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49 Cards in this Set
- Front
- Back
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What are the guidelines of US for looking at a fetus
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Aium guidelines
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What type of view of the heart should be obtained
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a 4 chamber view
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Should you look for the location and orientation of the heart
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yes, the heart should be central to slightly left and rotated to the left
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What is the view of the heart if you come a bit superior with the probe
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a 3 vessel view
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What is always larger the aorta or the pulmonary artery
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the pulmonary artery
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What should you be concerned about if the aorta is bigger than the pulmonary artery
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TOF
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Is it easy to detect pulmonary hypoplasia if you look at a posterior coronal image of the fetus
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no, because the ribcage maintains the contour of the fetus and therefore it is better to look anteriorly
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What are 6 abnormalities of fetal lung development
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pulmonary hypoplasia
cystic adenomatoid malformation of the lung congenital diaphragmatic hernia pulmonary sequestration laryngeal/tracheal atresia pulmonary hydrothorax |
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How do you measure pulmonary hypoplasia
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measure the thorax (in the same transverse view used to look at the 4 chamber heart) and compare the measurement to a standardized table
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In a coronal view of the fetus what is a rule of thumb for determining if a fetus has pulmonary hypoplasia
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compare the size of the thorax to the abdomen in coronal view.
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What is the ddx for skeletal dysplasia
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jeunes ATD, Thanatophoric dysplasia, achondrogenesis
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What is the DDX for oligohydraminos
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PROM, renal agenesis, renal obstruction
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What is the DDX for a small thorax
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pulmonary hypoplasia
oligohydraminos skeletal dysplasia |
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If a fetus has decreased amniotic fluid? , a small or abnormal extremity and a small thorax what should you suspect
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skeletal dysplasia
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Why does oligohydraminois cause a small thorax
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fluid is secreted and absorbed by the lungs (among other things) and the fluid acts a s a internal stent for normal lung development and lack of fluid and external compression causes pulm hypoplasia
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What is the ddx for a solid appearing intrathoracic fetal mass
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congenital cystic adenomatoid malformation
pulmonary sequestration laryngeal/tracheal/bronchial atresia congenital diaphragmatic hernia bronchial foregut abnormality |
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What is the DDX for cystic appearing intrathoracic fetal masses
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CCAM,
mediastinal cystic teratoma congenital diaphragmatic hernia Bronchopulmonary foregut abnormality Note: diaphragmatic hernia, bronchopulmonary foregut abnormality, CCAM are also solid appearing. |
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What is a CCAM
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Anomalous fetal development of terminal respiratory structures resulting in an adenomatoid proliferation of bronchiolar elements and cyst formation
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What are the 3 categories of CCAM
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type 1, 2 and 3
this is based on size of cyst and not really used |
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Can the cyst be so small in CCAM that you cant really see them
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yes, kinda like ARPKD (TYPE 3)
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Do type 3 CCAM appear solid
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yes this is the one that has many small cyst and appears as a large solid mass.
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How to you recongnize a type 3 CCAM
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it is a mass with increased echogenicity
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What is does a type 1 CCAM look like?
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It is a large cyst
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Can a CCAM be a large echogenic mass
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yes
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Can a CCAM be bilateral
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yes
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What are the 2 types of pulmonary sequestration
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intralobar and extralobar
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Where is the most common location for an extralobar pulmonary sequestration
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the left basal hemithorax
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Can a CCAM look similar to a pulmonary sequestration
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yes almost identical look
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What should you think about if there is a hyperechogenic mass in the thorax
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pulmonary sequestration or CCAM
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Can a pulmonary seqeustration go below the diaphragm
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yes,it can be subdiaphragmatic
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How do you differentiate a pulmonary sequestration from a CCAM
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by using color doppler and you will see blood flow to a sequestration.
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What are pulmonary sequestrations commonly associated with
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hydrothorax
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Can a pulmonary seqestration be bilateral
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yes
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Can both CCAMs and pulmonary sequestrations be bilateral
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yes
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Do all intrathoracic masses of fetus grow throughout pregnancy
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no, many disappear or decrease in size
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What percent of congenital diaphragmatic hernias are left sided
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90%
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What happens to the heart with diaphragmented hernia
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moves to the opposite side
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What is typical appearance of US of diaphragmatic hernia
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the heart pushed over to one side and the stomach above the diaphragm adjacent to the heart on a transverse view
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What determines the prognosis of a diaphragmatic hernia
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size of hernia
liver herniation size of visible lung |
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What is a hybrid lesion
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this is a combination of sequestration or CCAM and something else. Basically two of any pathology going on at the same time.
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What is the cause of upper respiratory tract agenesis
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this is caused by an insult that occur at 4-6 weeks and it is a narrowing or agenesis of trachea or upper respiratory tree.
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How to the lungs appear in laryngeal atresia
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bilateral echogenic
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How do the trachea and bronchi appear in layrngeal atreasia
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dilated and there is bilateral echogenic lungs
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What causes a fetal hydrothorax
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rupture or failure of fusion of thoracic channels
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What side does a fetal hydrothorax most commonly occur on
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the right side.
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If you dont see the stomach below the diaphragm what should be suspected
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a diaphragmatic hernia
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What should you suspect if there is an echogenic mass in the thorax and it has cyst within it
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Cystic adenomatoid malformation
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If you see an echogenic mass in the thorax and on doppler it has vessels what should you suspect
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pulmonary sequestration
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If you see bilateral echogenic masses in the thorax what should you suspect
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upper respiratory tract atresia
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