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  SPECIFICATION
COLOUR DOPPLER, 3D AND 4D ULTRASOUND IN GYNECOLOGY INFERTILITY AND OBSTETRICS 2e(hb)2011
Author: KUPESIC
ISBN: 9789350250907
Year: 2011
Publisher: JAYPEE BROTHERS MEDICAL PUBLISHERS PVT LTD.
Category: RADIOLOGY / IMAGING
Edition: 2
Format: Hard Cover
Language: English
Pages: 375
 ABOUT THE TITLE
The aim of this book is to inform interested readers about the advantages of color Doppler three and four dimensional ultrasound in gynecology infertility and obstetrics. Extensive demonstration of possible applications and illustrative figures of both normal and abnormal cases should enable sonographers to enrich the knowledge on ultrasound scanning of female patients.

Sanja Kupesic
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 TABLE OF CONTENTS
1. Physical Principles of the Doppler Effect and Its Application in Medicine ........................................................ 1
B Breyer
The Doppler Effect 1
Doppler Indices 3
Instrumentation for Doppler Measurements 4
Two Dimensional Flow Measurement 6
Basic Limitations of Doppler Examinations 7
Contrast Media 8
How to Reduce Problems 10
2. Normal Pelvic Anatomy Assessed by 2D, 3D and Color Doppler Ultrasound .................................................. 12
S Kupesic Plavsic, A Kurjak, K Baston
Uterus 12
Postmenopausal State 14
Cervix 14
Uterine Perfusion 14
Uterus in Newborn and Prepuberty 15
Vagina 16
Fallopian Tube 16
Ovaries 16
Newborn 19
Childhood 19
Perimenopausal and Postmenopausal State 19
3. Color Doppler and 3D Ultrasound of the Uterine Lesions ................................................................................ 22
S Kupesic Plavsic, A Kurjak, K Baston
Normal Uterus 22
Endometrial Polyps 23
Intrauterine Synechiae (Adhesions) 24
Adenomyosis 25
Endometrial Hyperplasia 25
Endometrial Carcinoma 26
Leiomyoma 29
Leiomyosarcoma 30
4. Adnexal Masses .................................................................................................................................................. 33
A Kurjak, S Kupesic Plavsic, U Honemeyer
The Main Basis of Angiogenesis 33
Tumor Neovascularization—Current Concepts 34
Evolution of 2D Conventional and Color Doppler Ultrasound in Imaging of Adnexal Tumor Angiogenesis 36
Three-Dimensional Ultrasound and Power Doppler Imaging of Benign and Malignant Adnexal Masses 38
Further Possibilities in the Evaluation of Tumor Angiogenesis 48
Zagreb Experience 50
Future Challenges 53
Color Doppler, 3D and 4D Ultrasound in Gynecology, Infertility and Obstetrics
xii
5. Ovarian Cancer Screening by 3D and 3D Power Doppler Ultrasound ............................................................. 58
A Kurjak, U Honemyer, S Kupesic Plavsic
Why to Screen for Ovarian Cancer? 58
Difficulties in Ovarian Cancer Screening 59
Attempts to Screen—Some Lessons Learned 60
Screening Tests 60
Target Populations 64
General Population 64
Ovarian Cancer Screening Trials 65
Ovarian Cancer—The Role of 3D Ultrasound and 3D Power Doppler Imaging 66
Zagreb Ovarian Cancer Screening Trial 68
6. Ovarian Endometriosis ...................................................................................................................................... 80
S Kupesic Plavsic, A Kurjak, K Baston
Symptoms 80
Endometriosis in Infertile Patients 80
Ultrasound Diagnosis 81
Combined Studies by Doppler Ultrasound and Ca-125 Values 83
Ovarian Endometrioma Assessed by 3D Ultrasound 85
7. Pelvic Inflammatory Disease............................................................................................................................. 89
S Kupesic Plavsic, A Kurjak, K Baston
Transvaginal Ultrasound and Color Doppler Assessment of PID 89
Tubo-ovarian Abscess 92
Chronic PID 92
Three-Dimensional Ultrasound 94
8. Endoscopic Surgery in Gynecology ..................................................................................................................... 96
V Sparac, A Kurjak, I Bekavac, S Kupesic Plavsic
Laparoscopy 96
Laparoscopy of Adnexal Lesions 99
Laparoscopic Myomectomy 102
Laparoscopic Hysterectomy 102
Laparoscopy in Gynecologic Oncology 103
Hysteroscopy 104
Diagnostic Hysteroscopy 105
Operative Hysteroscopy 106
9. Color Doppler and Three-Dimensional Ultrasound Imaging in Infertility ................................................... 112
S Kupesic Plavsic, A Kurjak, N Zafar
Uterine Causes of Infertility 112
Ovarian Causes of Infertility 120
Polycystic Ovarian Syndrome 123
Tubal Causes of Infertility 129
10. Color Doppler and 3D Power Doppler Hystero-Contrast-Salpingography ..................................................... 134
S Kupesic Plavsic, A Kurjak, N Zafar
Historical Development of the Ultrasonic Assessment of the Fallopian Tube 135
Ultrasound Contrast Agents 136
Technique of Hystero-contrast-salpingography 136
Requirements 136
Procedure 137
Gray-scale Hystero-contrast-salpingography 138
xiii
Contents
Pulsed Doppler Analysis of Tubal Patency 138
Color Doppler Hystero-contrast-salpingography 139
Review of Literature 140
Three-Dimensional Hysterosonosalpingography 141
11. Color Doppler and 3D US Imaging in Normal and Abnormal Early Pregnancy ............................................ 146
S Kupesic Plavsic, A Kurjak, N Zafar
Ultrasound Studies of the Uterus from Ovulation to Implantation 146
Uterine Findings Following Implantation 147
Placenta 148
Umbilical and Fetal Portion 150
3D Ultrasound Measurement of Nuchal Translucency 159
Doppler Assessment of Ductus Venosus 159
First Trimester Screening for Chromosomopathies: Nasal Bone and Fetal Heart 160
Pathology of Early Pregnancy 161
12. Ectopic Pregnancy ............................................................................................................................................. 168
S Kupesic Plavsic, A Kurjak, N Zafar
The Role of Biochemical Markers in Ectopic Pregnancy 169
The Role of Ultrasound in the Diagnosis of Tubal Ectopic Pregnancy 169
Color Doppler in Early Diagnosis of Tubal Ectopic Pregnancy 171
3D Ultrasound in the Assessment of Tubal Ectopic Pregnancy 174
Other Sites of Implantation 175
Therapy 178
13. The Assessment of Normal Fetal Anatomy ..................................................................................................... 182
U Honemeyer, A Kurjak, B Ahmed, S Kupesic Plavsic
Technological Improvements in Prenatal Diagnosis 182
Visualization of Normal Fetal Anatomy 185
Volumetry—Organ Volume Measurements 194
14. The Assessment of Abnormal Fetal Anatomy ................................................................................................. 198
A Kurjak, B Ahmed, U Honemeyer, S Kupesic Plavsic
Head and Neck 198
Fetal Spine 203
Heart 204
Abdomen 205
Skeleton and Extremities 207
Role of Color and Power Doppler Ultrasound 211
15. First Trimester Ultrasonographic Screening and Prenatal Diagnostic Methods ........................................... 217
K Gersak
First Trimester Ultrasonographic Screening 217
Prenatal Diagnostic Methods 221
4D US and Prenatal Diagnostic Methods 223
16. Genetic Approach to Fetal Abnormalities ........................................................................................................ 225
K Gersak
Morphological Characterization of Abnormalities 225
Recognition of the Pattern of Multiple Abnormalities 226
Establishment of Diagnosis 227
Assessment of Prognosis and Recurrent Risk 229
Color Doppler, 3D and 4D Ultrasound in Gynecology, Infertility and Obstetrics
xiv
17. Four-Dimensional Sonography in Perinatal Medicine .................................................................................... 231
A Kurjak, M Stanojevic, B Ahmed, Tikvica Luetic
Fetal Motility and 4D Ultrasound 231
Classification of Movement Patterns 232
Onset of Specific Fetal Behavioral Patterns Assessed by 3D/4D US 233
The First Trimester 233
The Second Trimester 234
The Third Trimester 235
New Scoring System for Fetal Neurobehavior Assessed by 3D and 4D Sonography 236
Multicentric Study 238
18. Gestational Trophoblastic Disease .................................................................................................................... 243
S Kupesic Plavsic, A Kurjak, K Baston
Hydatidiform Mole 243
Invasive Mole 245
Choriocarcinoma 246
Placental Site Trophoblastic Tumor 247
Zagreb Experience 247
Three-Dimensional Power Doppler (3D PD) 249
19. Clinical Sonographic Pearls .............................................................................................................................. 252
S Kupesic Plavsic
Pelvic Ultrasound Pearls 253
Uterus 253
Tubes 254
Cul-de-sac 254
Writing an Ultrasound Report 254
19.1: Amenorrhea 256
19.2: Abnormal Genital Tract Bleeding (Reproductive Age) 261
19.3: Menopause 270
19.4: Peri- and Postmenopausal Bleeding 274
19.5: Prolapse and Pelvic Floor Relaxation 280
19.6: Contraception 285
19.7: Infertility 290
19.8: Pelvic Inflammatory Disease 300
19.9: Pelvic Pain 306
19.10: Abnormal Pap Smear and Cervical Mass 314
19.11: Uterine Mass 320
19.12: Adnexal Mass 327
19.13: Breast Lumps 342
20. Obstetric Ultrasound Pearls............................................................................................................................. 349
S Kupesic Plavsic
20.1: First Trimester Ultrasound Examination 349
Nuchal Translucency Measurement (11 to 13 Weeks and 6 Days) 350
20.2: Second and Third Trimester Ultrasound Examination (Fetal Anatomy Scan) 351
20.3: Bleeding in Pregnancy 366
Writing an Obstetric Ultrasound Report 366
Index .................................................................................................................................................................. 373
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