Measurement of the transverse cerebellar diameter it means that the normality of the posterior fossa has been checked. Visualization of the orbits. Longitudinal view of the spine. Fetal Thorax Visualization of the lungs on a transverse scan. Four-chambers view of the heart it is recommended to include the outflow. Fetal Abdomen Measurement of the abdominal circumference AC.
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Measurement of the transverse cerebellar diameter it means that the normality of the posterior fossa has been checked. Visualization of the orbits.
Longitudinal view of the spine. Fetal Thorax Visualization of the lungs on a transverse scan. Four-chambers view of the heart it is recommended to include the outflow. Fetal Abdomen Measurement of the abdominal circumference AC. Visualization of the stomach and the anterior abdominal profile.
Visualization of the kidneys and bladder. Measurement of the femur length FL. Visualization of the direction of the foot. Gender Although the evaluation of the fetal gender is not included in the minimal standards required by most guidelines, however the patients require knowing it and therefore the ultrasonographer should be able to recognize the fetal penis and scrotum XY and the labia majora XX.
Detailed Assessment of Fetal Anatomy Head and Brain The measurements of BPD and HC are obtained on an axial scan of the fetal head showing the thalami, the cavum septi pellucidi and the frontal horns of the lateral ventricles transthalamic scan. By further tilting the probe caudally the posterior fossa is shown with the cerebellum and the cisterna magna transcerebellar scan.
By tilting the probe on the opposite side the orbits can be visualized transorbitary scan. A midsagittal scan shows the corpus callosum above the cavum septi pellucidi as well as the posterior fossa, where the cerebellar vermis and the fourth ventricle can be recognized. A parasagittal scan shows the different components of the lateral ventricle. Spine The spine can be evaluated in longitudinal, coronal and axial scans. The best longitudinal view is that one passing through the spine from the posterior to the anterior aspect, thus showing the vertebral canal; on the contrary an anterior-posterior scan is not good since the shadows caused by the vertebral bodies obscure the spinal canal.
An alternative way to visualize the spinal canal is the coronal scan passing through the laminae. The sonographic appearance of the spine on axial scan varies according to the level of section. Close to the spine further bony structures can be seen, such as the clavicles, the scapulae and the iliac wings. In this axial scan the four-chambers view of the heart is looked for.
In order to obtain a correct four-chambers view, the first step is to localize the stomach in an axial scan on the abdomen, and then moving the transducer cranially without tilting it: in such a way a confirmation of a normally left-sided heart as well as a correct heart section are easily obtained.
Two of the pulmonary veins opening in the left atrium. The interatrial septum with the interruption due to the foramen ovale. The atrioventricular valves: the tricuspid has a slightly lower septal insertion than the mitral valve. The interventricular septum. Once the four-chambers view has been obtained, by simply moving the transducer, it is possible to visualize the outflow tracts and the subaortic part membranous part of the interventricular septum.
The left outflow tract also called left long axis is obtained from the four-chambers view, by rotating the transducer towards the right fetal shoulder. In the left long axis the following structures can be evaluated: The connection between the left ventricle and the aorta.
The integrity of the subaortic part of the interventricular septum. The presence and function of the aortic valve.
By rotating the transducer from the long axis view towards the fetal head, the right outflow tract can be visualized. In the right short axis the following structures can be seen: The connection between the right ventricle and the pulmonary artery moving the transducer from the left to the right axis, the vessels crossover can be seen. The presence and function of the pulmonary valve.
Normal Fetal Anatomy
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