Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5802_Библиотеки_им_академика_М_И_Перельмана.pdf
Obstetrics
376
Mean renal lengths for gestational ages
PREPARATION
Full bladder for transabdominal imaging in 2
nd
trimester.
POSITION
Mother is in the supine position. Longitudinal axis view of the kidneys
obtained.
TRANSDUCER
Transabdominal: 3.0–5.0 MHz curvilinear transducer.
METHOD
Maximum long axis measurements are taken from the lower to the
upper pole, but excluding the adrenal glands. Enlarged kidneys are
associated with obstruction, multicystic dysplastic kidney, and polycystic kidney.
APPEARANCE
Elliptical structures with high-reective margins caused by peri-renal fat.
MEASUREMENTS
18 22 16–28
19 23 15–31
20 26 18–34
21 27 21–32
22 27 20–34
23 30 22–37
24 31 19–44
25 33 25–42
26 34 24–44
27 35 27–44
28 34 26–42
A coronal view through the kidney
(between cursors).
Mean renal lengths for gestational ages
377
A sagittal view through the kidney (LTK, between cursors).
Obstetrics
378
29 36 23–48
30 38 29–46
31 37 28–46
32 41 31–51
33 40 31–47
34 42 33–50
35 42 32–52
36 42 33–50
37 42 33–51
38 44 32–56
39 42 35–48
40 43 32–53
41 45 39–51
FURTHER READING
Cohen HL, Cooper J, Eisenberg P, Mandel FS, Gross BR, Goldman
MA, Barzel E, Rawlinson KF. Normal length of fetal kidneys:
Sonographic study in 397 obstetric patients. Am J Roentgenol.
1991; 157:545–548.
This page intentionally left blankThis page intentionally left blank
Obstetrics
380
Outer orbital diameter
PREPARATION
Full bladder for transabdominal imaging in 2
nd
trimester.
POSITION
Mother is in the supine position. Coronal plane through skull, approximately 2 cm posterior to the glabella-alveolar line or transverse plane
along the orbito-meatal line (2–3 cm below the biparietal diameter).
TRANSDUCER
Transabdominal: 3.0–6.0 MHz curvilinear transducer.
METHOD
The measurement is made from the lateral border of one orbit to the
lateral border of the other orbit. This measurement may be used in
place of the biparietal diameter (BPD) when BPD cannot be measured.
APPEARANCE
The orbits should be symmetric with both appearing equal and with
the largest possible diameter. Abnormal orbital diameters, both hypoand hyper-telorism, are evidence of a range of chromosomal and other
developmental disorders.
MEASUREMENTS
13 16
14 18
15 21
16 23
17 25
18 27
19 30
20 32
21 34
22 36
23 37
24 39
Outer orbital diameter
Outer orbital measurement (between cursors) from lateral border of orbit to opposite lateral
border.
25 41
26 43
27 44
28 46
29 47
30 49
31 50
32 51
33 52
34 53
35 54
381
FURTHER READING
Trout T, Budorick NE, Pretorius DH, McGahan, JP. Signicance
of orbital measurements in the fetus. J Ultrasound Med. 1994;
13:937–943.
Obstetrics
382
Nasal bone length
PREPARATION
Full bladder for transabdominal imaging in 2
nd
trimester.
POSITION
Mother is in the supine position. Fetus is viewed in the midsagittal plane.
TRANSDUCER
Transabdominal: 3.0–6.0 MHz curvilinear transducer.
METHOD
The fetal nasal bone is identied and measured at the level of the synostosis. Care is taken to keep the angle of insonation close to 45° or 135°.
APPEARANCE
Nasal bones appear as a linear echogenic structure. Absence or hypoplasia of the nasal bone is associated with trisomy 21 and with some
cases of trisomy 18 and 13.
MEASUREMENTS
11 2.3
12 2.8
13 3.1
14 3.8
15 4.3
16 4.7
17 5.3
18 5.7
19 6.3
20 6.7
21 7.1
22 7.5
23 7.9
Nasal bone length
The nasal bone length (between cursors) is estimated at the level of the synostosis.
383
24 8.3
25 8.5
26 8.9
27 9.2
28 9.8
29 9.8
30 10.0
31 10.4
32 10.5
33 10.8
34 10.9
35 11.0
Obstetrics
384
36 10.8
37 11.4
38 11.7
39 10.9
40 12.1
FURTHER READING
Sonek JD, McKenna D, Webb D, Croom C, Nicolaides K. Nasal
bone length throughout gestation: Normal ranges based on 3537
fetal ultrasound measurements. Ultrasound Obstet Gynecol.
2003; 21:152–155.
This page intentionally left blankThis page intentionally left blank