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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5820_Библиотеки_им_академика_М_И_Перельмана.pdf
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 380
25. Longitudinal image of the fetus to include the diaphragm.
Labeled: DIAPHRAGM
26. Biparietal diameter image at the level of the thalamus and the cavum septum
pellucidi. Measurement is from the outside of the near cranium to the inside of the far
cranium (leading edge to leading edge).
SCANNING TIP: Because of the obvious nature of the fetal measurements, specifics are
not included as part of the film labeling for the following measurement images.
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 381
PART V
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 382
27. Cerebellum with measurement.
28. Cisterna magnum with measurement.
29. Nuchal fold (done between 16 and 24 weeks) with measurement.
SCANNING TIP: The measurement of the nuchal
fold is not always routinely performed but should
be considered for the fetus of mothers over 35
years of age or when the mother has a lowerthan-normal serum alpha-fetoprotein level. The
extra fold of soft tissue visualized at the back of
the neck is considered a sonographic marker
for the second trimester detection of Down
syndrome.
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 383
PART V
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 384
30. Head circumference image at the same level as the biparietal diameter or use
the biparietal diameter image. Measurement is around the outline of the cranium.
Up-to-date ultrasound equipment provides tracking balls to trace the cranium or
calipers that open to outline the cranium.
31. Image of the choroid plexus.
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 385
32. Lateral ventricle with measurement.
PART V
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 386
33. Abdominal circumference image at the level of the junction of the umbilical vein
and portal vein sinus. Measurement is around the outline of the abdomen. The abdomen should appear round.
34. Long axis image of the femur with measurement from one ossi-
fied end of the femur to the other ossified end.
SCANNING TIP: For long bone measurements, cursors are placed at the bone-cartilage
interface. The cartilaginous ends of the bones are not included in the measurement.
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 387
PART V
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 388
35. Long axis image of the humerus with measure-
ment from one ossified end of the humerus to the
other ossified end.
36. Image of the lower portion of the leg.
37. Image of the radius and ulna.
Image Protocol for the Sonographic Study of the Second and Third Trimesters n 389
38. Image of a hand.
PART V