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MEASUREMENT
IN
ULTRASOUND
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MEASUREMENT
IN
A practical handbook
2nd edition
Paul S. Sidhu BSc MBBS MRCP FRCR DTM&H
Consultant Radiologist
Department of Radiology
King’s College Hospital
London, UK
Wui K. Chong MBBS MRCP FRCR
Associate Professor
University of North Carolina Hospital
Department of Radiology
Chapel Hill
North Carolina, USA
Keshthra Satchithananda BDS, FDSRCS, MBBS, FRCS, FRCR, CON
Consultant Radiologist
Department of Radiology
King’s College Hospital
London, UK
CRC Press Taylor & Francis Group 600 0 Broken Sound Park way NW, Suite 300 Boca Rato n, FL 33487-2742
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No claim t o original U. S. Government work s Version Date: 2 0151103
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CONTENTS

Editors xi Contributing authors xiii
ADULTS
1 UPPER ABDOMINAL 3
Anu E. Obaro, Venus Hedayati, ColinR. Deane, KeshthraSatchithananda, and PaulS.Sidhu
Liver size 4 Liver brosis assessment 6 Biliary tree 8 Gallbladder and gallbladder wall 12 Spleen 14 Pancreas 18 Pancreatic duct (adult) 20 Adrenal glands (adult) 22 Diaphragm 24 Portal vein 26 Hepatic veins 30 Hepatic artery 32 Celiac and superior mesenteric arteries 36 Doppler ultrasound measurement of post-prandial intestinal
blood ow 38
Inferior mesenteric artery 40
2 URINARY TRACT 43
Venus Hedayati, Colin R. Deane, Keshthra Satchithananda, and PaulS.Sidhu
Kidneys 44 Evaluation of acute renal obstruction with intrarenal Doppler 48 Renal circulation and renal artery 50 Retroperitoneal lymph nodes 54 Bladder volume and residual volume 56 Bladder wall 60 Functional bladder imaging 62
Contents
vi
3 ORGAN TRANSPLANTATION 65
Anu E. Obaro, Venus Hedayati, ColinR. Deane, KeshthraSatchithananda, and PaulS.Sidhu
Liver transplantation 66 Renal transplantation 70 Renal artery stenosis in transplantation 74 Pancreas transplantation 78
4 GENITAL TRACT 81
Venus Hedayati, Dean Y. Huang, Keshthra Satchithananda, and PaulS.Sidhu (Male Genital Tract); Induni Douglas, Anthony E. Swartz, and Wui K. Chong (Female Genital Tract)
Male Genital Tract 82
Testes 82 Epididymis 86 Varicoceles 88 Prostate (transrectal sonography) 92 Seminal vesicles (transrectal sonography) 94 Penis 98
Female Genital Tract 102
Ovarian volume (transvaginal sonography) 102 Ovarian follicles (transvaginal sonography) 104 Uterus (transvaginal sonography) 106 Endometrial stripe thickness (transvaginal sonography) 108
5 GASTROINTESTINAL TRACT 111
Anu E. Obaro and Suzanne M. Ryan
Appendix 112 Upper gastrointestinal tract wall (endoscopic ultrasound) 114 Gastrointestinal tract wall (transabdominal ultrasound) 118 Anal endosonography 122
6 SUPERFICIAL STRUCTURES 125
Keshthra Satchithananda and PaulS.Sidhu
Parathyroid glands 126 Submandibular salivary glands 128 Parotid salivary glands 130 Thyroid gland 132 Lymph nodes in the neck 136
Contents
Orbits (extraocular muscles) 140 Orbits (optic nerve) 142
7 PERIPHERAL VASCULAR (ARTERIAL) 143
Colin R. Deane and Paul S. Sidhu
Upper limbs (peripheral arteries) 144 Abdominal aorta and common iliac arteries 148 Lower limbs (peripheral arteries) 152 Lower limbs (peripheral artery bypass grafts) 156 Hemodialysis access stulas and grafts 160 Extracranial arteries 164 Transcranial Doppler (TCD) ultrasound 172
8 PERIPHERAL VASCULAR (VENOUS) 179
Colin R. Deane and PaulS.Sidhu
Inferior vena cava (IVC) 180 Neck veins 182 Leg veins 184
9 MUSCULOSKELETAL SYSTEM 187
Bhavna Batohi, KeshthraSatchithananda, and DavidElias
General considerations 188 Upper Limb: Shoulder 190
Long head of biceps 190 Subscapularis tendon 192 Supraspinatus tendon 194 Infraspinatus tendon 196
Upper limb: elbow 198
Anterior joint space and distal biceps tendon 198 Olecranon fossa, ulnar nerve, and distal triceps 202 Lateral elbow 204 Medial elbow 206
Upper limb: wrist 208
Dorsal tendons 208 Carpal tunnel 210
Lower limb: hips 214
Hip effusion 214 Developmental dysplasia of the hip 216
vii
Contents
viii
Lower limb: knee 220
Anterior knee 220 Posterior knee 224
Lower limb: ankle 226
Anterior, medial, and lateral tendons 226 Achilles tendon 230
Lower limb: foot 232
Plantar fascia 232
Interdigital web spaces 234
PEDIATRIC AND NEONATAL
10 UPPER ABDOMEN 237
Annamaria Deganello, Maria E. Sellars, and Paul S. Sidhu
Liver (pediatric) 238 Gallbladder (neonatal) 240 Gallbladder (pediatric) 242 Common bile duct (pediatric) 246 Spleen (pediatric) 248 Pancreas (pediatric) 252 Adrenal glands (neonatal) 254 Adrenal glands (infant) 258 Pyloric stenosis 260
11 RENAL TRACT 263
Annamaria Deganello and MariaE.Sellars
Renal size (pediatric) 264 Renal size (neonates and infants) 268 Renal pelvic diameter (fetus and neonate) 274 Ureterovesical jets (infants and children) 278
12 PEDIATRIC UTERUS, OVARY, AND TESTIS 281
Induni Douglas, Anthony E. Swartz, Wui K. Chong, and Paul S. Sidhu
Uterus (transabdominal sonography) 282 Ovarian volume (transabdominal sonography) 284 Testis 286
Contents
13 NEONATAL BRAIN 289
Annamaria Deganello and PaulS.Sidhu
Neonatal brain (ventricular size) 290 Neonatal brain (Doppler ultrasound) 294
OBSTETRICS
14 OBSTETRICS 299
Induni Douglas, Anthony E. Swartz, and Wui K. Chong
Gestational sac 300 Embryonic/fetal heart rate (1 Crown rump length 308 Discriminatory levels for diagnosis of pregnancy failure in rst
trimester (transvaginal ultrasonography) 310 Nuchal translucency thickness measurement 312 Nuchal fold thickness measurement 314 Biparietal diameter 316 Head circumference 320 Abdominal circumference 324 Fetal femur length 328 Multiple fetal parameters in the assessment of gestational age 332 Multiple fetal parameters in the assessment of fetal weight 336 Fetal humerus length 354 Transcerebellar diameter 358 Head to abdominal circumference ratio 362 Transcerebellar diameter to abdominal circumference ratio 364 Systolic/diastolic ratio in the umbilical artery 366
Cerebral Ventricular Measurements 368
Lateral ventricle transverse atrial measurement (atrial size) 368 Cisterna magna measurements 370 Thoracic circumference 372 Renal pelvis diameter 374 Mean renal lengths for gestational ages 376 Outer orbital diameter 380 Nasal bone length 382 Fetal stomach diameter measurements 386 Fetal colon measurement 388 Fetal small bowel measurements 390
st
trimester) 304
ix