태아 초음파 검사법.

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Presentation transcript:

태아 초음파 검사법

임신 시기에 따른 초음파 검사 항목 First Trimester Gestational sac location Embryo identification Crown-rump length Fetal heart motion Fetal number Uterus and adnexal evaluation

Gestational Sac

Yolk Sac

Yolk Sac & Fetus

Crown Rump Length

임신 시기에 따른 초음파 검사 항목 Second and Third Trimester Fetal number Presentation Fetal heart motion Placental location Amnionic fluid volume Gestational age Survey of fetal anatomy Evaluation for maternal pelvic masses

Detection of Fetal anomaly 태아의 형태적 이상유무를 확인 검사자의 경험 및 숙련도 초음파 기기의 해상도 등의 한계가 문제 Overall sensitivity of sonography in detecting fetal defects was 53%.

Head and Spine Hydrocephalus (Ventriculomegaly) Most cases are associated with other anomaly Ten percent were associated with chromosomal abnormalities Lateral ventricular atrium 6-9 mm (15-35 weeks) Greater than 10 mm -> ventriculomegaly Dangling choroid plexus

Head and Spine Neural tube defects Anencephaly Absence of cranium with cerebral hemisphere Extreme diminution of adrenal gland size Gross hydramnios The first fetal malformation to be diagnosed prenatally by sonography

Head and Spine Spina bifida Usually in the lumbosacral vertebrae Meningocele Meningomyelocele Meningoencephalocele

Head and Spine Arnold-Chiari malformation Cerebral ventriculomegaly Frontal bone scalloping (lemon sign) Abnormal curvature of the cerebellum (banana sign) Obliteration of cisterna magna

Lemon & Banana Sign

Head and Spine Cystic hygroma Cleft lip and palate Lymphatic system malformation Nuchal region Associated with fetal hydrops and chromosomal abnormalities Cleft lip and palate

Cystic hygroma

Thorax Heart anomaly Diaphragmatic hernia Most commonly recognized birth defect Frequently associated with aneuploidy Four-chamber view Diaphragmatic hernia Incomplete fusion of the pleuroperitoneal membrane Cystic structure behind the left atrium Absence of abdominal stomach bubble Associated hydramnios

Diaphragmatic Hernia

Abdomen Abdominal wall defects Omphalocele Yes Midline Variable More common Gastroschisis No Right to umbilicus Intestine Less common Sac Location Content Associated anomaly Chromosomal Abnormalities

Abdomen Gastrointestinal atresia Esophageal atresia Tracheoesophageal fistula Duodenal atresia Double bubble sign

Abdomen Renal agenesis Cystic renal disease More frequent in males Oligohydramnios and pulmonary hypoplasia Cystic renal disease polycystic kidney Multicystic dysplastic kidney Chronic obstructive uropathy

BPD 측정 Level

BPD & Femur

Face

Foot & Umbilical Cord

Mouth

Scrotum

Testis

Hydrocele

Amniotic Band