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_5841_Библиотеки_им_академика_М_И_Перельмана
.pdf
Second Trimester 109
Fig. 4.103: Scattered echogenic foci with distal acoustic
shadowing in a case of meconium peritonitis
Fig. 4.104: Dense hyperechoic foci (arrows) seen in
the periphery in a case of meconium peritonitis
Fig. 4.105: Meconium peritonitis with a meconium
pseudocyst (solid line) with debris seen within it
110 Step by Step Ultrasound in Obstetrics
Fig. 4.106: Gastroschisis with bowel segments
(solid line) seen floating freely in the amniotic fluid
Fig. 4.107: Anterior abdominal wall defect (gastro-
schisis) with the umbilical cord insertion on the side of
the lesion (solid line) as seen on color flow mapping
Second Trimester 111
Fig. 4.108: Omphalocele with ascitic fluid and the
umbilical cord (arrow) inserted on the tip of the lesion
Fig. 4.109: Omphalocele (solid line) seen in
a case of trisomy 18
112 Step by Step Ultrasound in Obstetrics
Fig. 4.110: Multiple foci of hepatic calcification in a
case of intrauterine infection
Fig. 4.111: Fetal hepatomegaly with calcification and
ascites seen in a case of toxoplasmosis infection
Second Trimester 113
Fig. 4.112: Fetal splenomegaly (labelled) in a case of
severe fetal hydrops
Fig. 4.113: Longitudinal scan of a normal kidney with
its characteristic reniform shape
114 Step by Step Ultrasound in Obstetrics
Fig. 4.114: Transverse section through the fetal abdo-
men showing both kidneys (solid line) on either side of
the spine (dashed line)
Fig. 4.115: Longitudinal scan of a normal kidney in the
third trimester in a fetus of 33 weeks and 4 days. Note
the central echogenic area (solid line) with hypoechoic
pyramids (arrowheads)
Second Trimester 115
Fig. 4.116: Fetal adrenal glands as seen normally (solid
lines). Be careful not to mistake the adrenal for a kidney
especially in cases of renal agenesis. To differentiate
remember that the adrenal gland does not have central
sinus echoes and a reniform shape
Fig. 4.117: Obstruction of the urinary tract at the bladder
outlet with an overdistended urinary bladder, dilated
ureters on both sides and a bilateral hydronephrosis
116 Step by Step Ultrasound in Obstetrics
Fig. 4.118: Anteroposterior diameter of the renal pelvis (solid
line). The values for the anteroposterior diameter of the renal
pelvis (measured on a transverse view through the kidney) are
from 15 to 20 weeks of gestation < 04 mm is normal, 04 to 07 mm
is borderline and > 08 mm is abnormal or hydronephrotic. From
20 weeks onwards < 06 mm is normal, 06 to 09 is borderline
and > 10 mm is abnormal or hydronephrotic. Be careful that
borderline cases are to be reviewed by serial scans before
labelling them as hydronephrotic
Fig. 4.119: Pelvi-ureteric junction obstruction with a dilated renal
pelvis (solid line) with dilated calyces (arrowheads) No ureteric
dilatation is seen
Second Trimester 117
Fig. 4.120: Bilateral echogenic kidneys which are
dysplastic and small with very less pelviectasis. This is
not a reduction in hydronephrosis as the improvement
with dysplastic kidney is because the renal function is
poor or absent and is not going to improve even after
the obstruction is corrected
Fig. 4.121: Bladder outlet obstruction with dilatation of
the proximal urethra (solid line) and a thickened urinary
bladder wall (arrowhead)
118 Step by Step Ultrasound in Obstetrics
Fig. 4.122: Multicystic dysplastic kidney with multiple
cysts and no normal renal parenchyma seen
Fig. 4.123: Bilateral multicystic dysplastic kidney with
severe oligohydramnios
Соседние файлы в папке Библиотека им академика М.И. Перельмана