Maureen McDaniel, MEd, RDMS, RDCS, RVT Sagittal Coronal Transverse - - PDF document

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Maureen McDaniel, MEd, RDMS, RDCS, RVT Sagittal Coronal Transverse - - PDF document

Feb 16, 2024 348 likes •885 views

Maureen McDaniel, MEd, RDMS, RDCS, RVT Sagittal Coronal Transverse Also called multiplaner, surface rendering, volume scanning Originated about 25 years ago More widely available 1990s Get the middle point in the

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Maureen McDaniel, MEd, RDMS, RDCS, RVT

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Sagittal Coronal Transverse

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Also called multiplaner, surface rendering,

volume scanning

Originated about 25 years ago More widely available 1990’s

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Get the middle point in the picture in 2D

For face this is the profile

Angle transducer all the way to side

Want to start in amniotic fluid

Move smoothly through anatomy till you reach other

side

Hopefully ending in amniotic fluid

The machine then calculates volume, based on the 2D

images obtained

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After you have the quad screen

Cut off surrounding objects Adjust transparency for desired effect

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Tissue Heating Cavitation

Gas bubbles developing within tissues due to

prolonged exposure.

Caviation effects are possible within range used

for diagnostic examination

Transient cavitation

Bursting of bubbles causing cellular damage

Rise in temperature of 2⁰C

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AIUM clearly discourages US for fun Scanning for parents increases scan time AIUM prohibits videotaping because it

lengthens scan time

What are we gaining? Extra charge for insurance companies Must be ordered by perinatologist—not OB

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3 D Technology Approved October 1999 Currently, two-dimensional (2D) gray-scale real-time sonography is the primary method of medically indicated anatomic imaging with ultrasound. While three-dimensional (3D) sonography may be helpful in diagnosis, it should not be considered more than a developing technology. Its role is restricted to an adjunct of, but not a replacement for, 2D ultrasound. As with any developing technology, its diagnostic value may improve, and its diagnostic role will be periodically re-evaluated.

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The new position statement is as follows: The AIUM advocates the responsible use of diagnostic ultrasound for all fetal imaging. The AIUM understands the growing pressures from patients for the performance of ultrasound examinations for bonding and reassurance purposes largely driven by the improving image quality of 3D sonography and by more widely available information about these advances. Although there is only preliminary scientific evidence that 3D sonography has a positive impact on parental--fetal bonding, the AIUM recognizes that many parents may pursue scanning for this purpose.

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As Low As Reasonably

Achievable

Benefits must outweigh the risks Only when medically indicated

Determining gender is not medically indicated

unless risk of x-linked disease

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Maternal body habitus!!!!! Not enough amniotic fluid Face looking down Face looking up but into or against placenta Arms or legs in front of face If scanning extremities, almost always have

problems with surrounding structures

Only a problem for 3D, not 4D

Fetal movement Sonographer not keeping steady movement across

structure

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  • oh, aah
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Color Anyone?

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Face looking into placenta

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scary

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Even scarier

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I’m an alien

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OB

Cleft lip and palate

Usually ordered after previously seen in 2D

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Central nervous system anomaly

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2D images 3D image

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2D image 3D images

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Polycystic ovaries Uterine anomalies

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Severity of ventricular septal defect Mitral valve regurge Mitral valve repair Problems with movement

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Vein of Galen aneurysms Periventricular leukomalacia Ventriculomegally Holoprosencephaly Circle of Willis

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2D images of ventriculomegaly and periventricular leukomalacia 3D imaging of same infant

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Breast tumor with power angio

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Echotexture

cystic or solid; homogeneous or heterogeneous

Shape

taller than wide

Shadowing

bilateral or unilateral

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Higher accuracy for staging esophageal,

gastric, colo-rectal cancer

Used to show effects of chemo/radiation

therapy

Follow up for early detection of recurrences

after tumor resection

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2D image of lining of GI tract

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If non-moving object, can acquire all three

planes in time it takes to acquire one

Physician can manipulate images later if

proper recording techniques are used

Procedures

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Movement of object or sonographer Operator dependent Physician may take longer to read study

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Fine needle biopsies Ethanol ablation RF ablation Cryoablation Catheter placement for drainage

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Adds time as a forth dimension Place probe.

Mechanics inside move angle for you. Very large probe

Less room for operator error Same constraints as 3D

Need amniotic fluid, fetal position

Great for real-time procedures

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Most sonographers retire due to MSI

Carpel tunnel

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4D is coined by GE Live 3D used by other manufacturers ATL (now Philips) had live 3D before GE introduced

4D

Marketed to public rather than Doctors and

Sonographers—why?

Why marketed for OB instead of other modalities? Similar to Pharmaceuticals Is this marketing to public effective?

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