CiNii 図書 - Ultrasound diagnosis in obstetrics and gynecology

It will be a long time before the quality of this profusely illustrated book is overtaken and the present spate of books on the subject of obstetric ultrasound may, as a result, suffer a numerical set-back - especially with translation into English which will "deliver the milk on everyone's doorstep". Two of the authors studied in our department in Glasgow and worked like If there are any rewards for teaching, then we humble Scots who demons. have had the privilege have had more than our share as a result of the pride with which we regard our pupils. In my own old age and looking back over the last thirty years, the innumer able difficulties, set-backs and disappointments have been more than compen- sated for by those who have turned the subject from a laughable eccentricity (as I have at one time experienced) into a science of increasing exactitude. This transformation has come about, not by any efforts of mine, but by the enthusiasm and ingenuity of those who would probably have achieved as much on their own if given the encouragement which I ultimately received in Glasgow University life. Limbo must be the expected lot of most of us ordinary mortals but the work lives on. And so, in this reminiscent and philosophical mood I beg leave to quote a little poem which I wrote at an age when young men do that sort of thing.

1 Physics and Instrumentation in Diagnostic Ultrasound.- 1.1 Propagating Properties of Ultrasound.- 1.2 Grey-Scale Sonography.- 1.2.1 Acoustic Impedance Mismatch.- 1.2.2 Attennuation by Tissue.- 1.3 Transducer Beam Pattern.- 1.3.1 Geometry of Reflecting Interfaces.- 1.3.2 Principle of Grey-Scale Sonography.- 1.4 Quality of Image and Frame Rate.- 1.5 Real-Time Scanning.- 1.6 Simple and Compound Scanning.- 1.7 Contact and Water-Path Coupling.- 1.8 Current Instrumentation.- 1.8.1 Articulated Arm Manual Contact Scanner.- 1.8.2 Linear Array Scanner.- 1.8.3 Mechanical Sector Scanner.- 1.8.4 Water-Path Scanner.- 1.9 Future Developments.- References.- 2 Safety of Diagnostic Ultrasound.- 2.1 Primary Effects.- 2.1.1 Heat Production.- 2.1.2 Pseudocavitation and Microstreaming.- 2.1.3 Chemical Effects.- 2.2 Biologic Effects.- 2.2.1 Tissue Lesions and Ultrastructural Changes in Cells.- 2.2.2 Teratogenicity.- 2.2.3 Mutagenicity.- 2.2.4 Comutagenicity.- 2.2.5 Other Effects.- 2.3 The Problem of Safe Levels.- 2.4 Concluding Remarks.- References.- 3 Examination of the Female Pelvis.- 3.1 General.- 3.1.1 Selection of Equipment.- 3.1.2 Examination Procedure.- 3.1.3 Findings.- References.- 3.2 Pelvimetry.- References.- 4 Pregnancy (First Trimester).- 4.1 Normal Development.- 4.1.1 Definition of Terms, Basic Embryology.- 4.1.2 Earliest Detection of Intrauterine Pregnancy.- 4.1.3 Five Weeks: Morphology and Biometry of the Gestational Sac.- 4.1.4 Six Weeks: Embryonic Structures, Viability.- 4.1.5 Seven Weeks.- 4.1.6 Eight Weeks: Yolk Sac.- 4.1.7 Nine to Eleven Weeks: Biometry, Embryo fetal Structures.- References.- 4.2 Abnormalities in the First Trimester.- 4.2.1 Blighted Ovum.- 4.2.2 Missed Abortion.- 4.2.3 Hydatidiform Mole.- 4.3 Ectopic Pregnancy.- 4.3.1 Detection of an Intact Intrauterine Pregnancy.- 4.3.2 Demonstration of an Intact Ectopic Pregnancy in the Cul-de-Sac or Adnexal Region.- 4.3.3 Complex Adnexal Masses.- 4.3.4 Fluid in the Abdomen or Cul-de-Sac.- 4.3.5 Principal Sources of Misdiagnosis in Patients with a Positive Pregnancy Test, No Visible Gestational Sac, and Suspected Ectopic Pregnancy.- References.- 4.4 Tumors Associated with Pregnancy.- References.- 4.5 The Kidney in Pregnancy.- References.- 5 Multiple Pregnancy.- References.- 6 Amniocentesis.- References.- 7 Normal Fetal Anatomy in the Second and Third Trimesters.- 7.1 Examination Procedure.- 7.1.1 Face.- 7.1.2 Brain.- 7.1.3 Spine.- 7.1.4 Thorax.- 7.1.5 Abdomen.- 7.1.6 Urogenital Tract.- 7.1.7 Genitalia.- 7.1.8 Extremities.- References.- 7.2 Ultrasound Biometry in the Second and Third Trimester.- 7.2.1 Introduction.- 7.2.2 Ultrasound Cephalometry.- 7.2.3 Fetal Trunk Measurements.- 7.2.4 Measurement of the Fetal Extremities.- References.- 7.3 Diagnosis of Intrauterine Growth Retardation.- 7.3.1 Diagnostic Criteria, Possible Screening Methods.- 7.3.2 Technique and Accuracy of Measurement.- References.- 7.4 Estimation of Fetal Weight.- References.- 7.5 Critical Reading of the Biometry Literature.- 7.5.1 Importance of a Critical Approach.- 7.5.2 Why Fetal Biometry.- 7.5.3 How are Normal Values Derived.- 7.5.4 Selection of the Patients.- 7.5.5 Type of Studies: Cross-Sectional or Longitudinal.- 7.5.6 Sample Size.- 7.5.7 Study Design.- 7.5.8 Curve Fitting.- 7.5.9 What is the Basic Idea of Regression Analysis?.- 7.5.10 Linear Regression Analysis.- 7.5.11 Polynomial Regression Analysis.- 7.5.12 The Coefficients of Correlation and of Determination.- 7.5.13 The F Test.- 7.5.14 Prediction from Equations.- 7.5.15 How to Compute the Confidence Limits.- 7.5.16 Summary.- References.- 7.6 Estimation of Gestational Age.- 7.6.1 Definitions.- 7.6.2 Parameters Proposed for Estimation of Gestational Age.- 7.6.3 Selection of Appropriate Table.- 7.6.4 What to Do When Different Parameters Provide Different Estimates.- 7.6.5 How to Report the Results.- 7.6.6 The Use of Computers for the Reporting of Obstetrical Examinations.- References.- 7.7 Normal Growth of Fetal Parameters.- 7.7.1 Crown-Rump Length.- 7.7.2 Cranial Parameters.- 7.7.3 Thoracic and Abdominal Organs.- 7.7.4 Long Bones.- 7.7.5 Estimated Fetal Weight.- References.- 8 Fetal Malformations.- 8.1 Signs Suggesting the Presence of a Malformation.- References.- 8.2 Neural Tube Defects.- 8.2.1 Anencephaly.- 8.2.2 Spina Bifida.- 8.2.3 Encephalocele.- References.- 8.3 Malformations of the Brain.- 8.3.1 Hydrocephalus.- 8.3.2 Microcephaly.- References.- 8.4 Malformations Involving the Abdomen and Gastrointestinal Tract.- 8.4.1 Abdominal Wall Defects.- 8.4.2 Intraabdominal Structural Abnormalities.- References.- 8.5 Malformations of the Urogenital Tract.- 8.5.1 Potter'1 Physics and Instrumentation in Diagnostic Ultrasound.- 1.1 Propagating Properties of Ultrasound.- 1.2 Grey-Scale Sonography.- 1.2.1 Acoustic Impedance Mismatch.- 1.2.2 Attennuation by Tissue.- 1.3 Transducer Beam Pattern.- 1.3.1 Geometry of Reflecting Interfaces.- 1.3.2 Principle of Grey-Scale Sonography.- 1.4 Quality of Image and Frame Rate.- 1.5 Real-Time Scanning.- 1.6 Simple and Compound Scanning.- 1.7 Contact and Water-Path Coupling.- 1.8 Current Instrumentation.- 1.8.1 Articulated Arm Manual Contact Scanner.- 1.8.2 Linear Array Scanner.- 1.8.3 Mechanical Sector Scanner.- 1.8.4 Water-Path Scanner.- 1.9 Future Developments.- References.- 2 Safety of Diagnostic Ultrasound.- 2.1 Primary Effects.- 2.1.1 Heat Production.- 2.1.2 Pseudocavitation and Microstreaming.- 2.1.3 Chemical Effects.- 2.2 Biologic Effects.- 2.2.1 Tissue Lesions and Ultrastructural Changes in Cells.- 2.2.2 Teratogenicity.- 2.2.3 Mutagenicity.- 2.2.4 Comutagenicity.- 2.2.5 Other Effects.- 2.3 The Problem of Safe Levels.- 2.4 Concluding Remarks.- References.- 3 Examination of the Female Pelvis.- 3.1 General.- 3.1.1 Selection of Equipment.- 3.1.2 Examination Procedure.- 3.1.3 Findings.- References.- 3.2 Pelvimetry.- References.- 4 Pregnancy (First Trimester).- 4.1 Normal Development.- 4.1.1 Definition of Terms, Basic Embryology.- 4.1.2 Earliest Detection of Intrauterine Pregnancy.- 4.1.3 Five Weeks: Morphology and Biometry of the Gestational Sac.- 4.1.4 Six Weeks: Embryonic Structures, Viability.- 4.1.5 Seven Weeks.- 4.1.6 Eight Weeks: Yolk Sac.- 4.1.7 Nine to Eleven Weeks: Biometry, Embryo fetal Structures.- References.- 4.2 Abnormalities in the First Trimester.- 4.2.1 Blighted Ovum.- 4.2.2 Missed Abortion.- 4.2.3 Hydatidiform Mole.- 4.3 Ectopic Pregnancy.- 4.3.1 Detection of an Intact Intrauterine Pregnancy.- 4.3.2 Demonstration of an Intact Ectopic Pregnancy in the Cul-de-Sac or Adnexal Region.- 4.3.3 Complex Adnexal Masses.- 4.3.4 Fluid in the Abdomen or Cul-de-Sac.- 4.3.5 Principal Sources of Misdiagnosis in Patients with a Positive Pregnancy Test, No Visible Gestational Sac, and Suspected Ectopic Pregnancy.- References.- 4.4 Tumors Associated with Pregnancy.- References.- 4.5 The Kidney in Pregnancy.- References.- 5 Multiple Pregnancy.- References.- 6 Amniocentesis.- References.- 7 Normal Fetal Anatomy in the Second and Third Trimesters.- 7.1 Examination Procedure.- 7.1.1 Face.- 7.1.2 Brain.- 7.1.3 Spine.- 7.1.4 Thorax.- 7.1.5 Abdomen.- 7.1.6 Urogenital Tract.- 7.1.7 Genitalia.- 7.1.8 Extremities.- References.- 7.2 Ultrasound Biometry in the Second and Third Trimester.- 7.2.1 Introduction.- 7.2.2 Ultrasound Cephalometry.- 7.2.3 Fetal Trunk Measurements.- 7.2.4 Measurement of the Fetal Extremities.- References.- 7.3 Diagnosis of Intrauterine Growth Retardation.- 7.3.1 Diagnostic Criteria, Possible Screening Methods.- 7.3.2 Technique and Accuracy of Measurement.- References.- 7.4 Estimation of Fetal Weight.- References.- 7.5 Critical Reading of the Biometry Literature.- 7.5.1 Importance of a Critical Approach.- 7.5.2 Why Fetal Biometry.- 7.5.3 How are Normal Values Derived.- 7.5.4 Selection of the Patients.- 7.5.5 Type of Studies: Cross-Sectional or Longitudinal.- 7.5.6 Sample Size.- 7.5.7 Study Design.- 7.5.8 Curve Fitting.- 7.5.9 What is the Basic Idea of Regression Analysis?.- 7.5.10 Linear Regression Analysis.- 7.5.11 Polynomial Regression Analysis.- 7.5.12 The Coefficients of Correlation and of Determination.- 7.5.13 The F Test.- 7.5.14 Prediction from Equations.- 7.5.15 How to Compute the Confidence Limits.- 7.5.16 Summary.- References.- 7.6 Estimation of Gestational Age.- 7.6.1 Definitions.- 7.6.2 Parameters Proposed for Estimation of Gestational Age.- 7.6.3 Selection of Appropriate Table.- 7.6.4 What to Do When Different Parameters Provide Different Estimates.- 7.6.5 How to Report the Results.- 7.6.6 The Use of Computers for the Reporting of Obstetrical Examinations.- References.- 7.7 Normal Growth of Fetal Parameters.- 7.7.1 Crown-Rump Length.- 7.7.2 Cranial Parameters.- 7.7.3 Thoracic and Abdominal Organs.- 7.7.4 Long Bones.- 7.7.5 Estimated Fetal Weight.- References.- 8 Fetal Malformations.- 8.1 Signs Suggesting the Presence of a Malformation.- References.- 8.2 Neural Tube Defects.- 8.2.1 Anencephaly.- 8.2.2 Spina Bifida.- 8.2.3 Encephalocele.- References.- 8.3 Malformations of the Brain.- 8.3.1 Hydrocephalus.- 8.3.2 Microcephaly.- References.- 8.4 Malformations Involving the Abdomen and Gastrointestinal Tract.- 8.4.1 Abdominal Wall Defects.- 8.4.2 Intraabdominal Structural Abnormalities.- References.- 8.5 Malformations of the Urogenital Tract.- 8.5.1 Potter'1 Physics and Instrumentation in Diagnostic Ultrasound.- 1.1 Propagating Properties of Ultrasound.- 1.2 Grey-Scale Sonography.- 1.2.1 Acoustic Impedance Mismatch.- 1.2.2 Attennuation by Tissue.- 1.3 Transducer Beam Pattern.- 1.3.1 Geometry of Reflecting Interfaces.- 1.3.2 Principle of Grey-Scale Sonography.- 1.4 Quality of Image and Frame Rate.- 1.5 Real-Time Scanning.- 1.6 Simple and Compound Scanning.- 1.7 Contact and Water-Path Coupling.- 1.8 Current Instrumentation.- 1.8.1 Articulated Arm Manual Contact Scanner.- 1.8.2 Linear Array Scanner.- 1.8.3 Mechanical Sector Scanner.- 1.8.4 Water-Path Scanner.- 1.9 Future Developments.- References.- 2 Safety of Diagnostic Ultrasound.- 2.1 Primary Effects.- 2.1.1 Heat Production.- 2.1.2 Pseudocavitation and Microstreaming.- 2.1.3 Chemical Effects.- 2.2 Biologic Effects.- 2.2.1 Tissue Lesions and Ultrastructural Changes in Cells.- 2.2.2 Teratogenicity.- 2.2.3 Mutagenicity.- 2.2.4 Comutagenicity.- 2.2.5 Other Effects.- 2.3 The Problem of Safe Levels.- 2.4 Concluding Remarks.- References.- 3 Examination of the Female Pelvis.- 3.1 General.- 3.1.1 Selection of Equipment.- 3.1.2 Examination Procedure.- 3.1.3 Findings.- References.- 3.2 Pelvimetry.- References.- 4 Pregnancy (First Trimester).- 4.1 Normal Development.- 4.1.1 Definition of Terms, Basic Embryology.- 4.1.2 Earliest Detection of Intrauterine Pregnancy.- 4.1.3 Five Weeks: Morphology and Biometry of the Gestational Sac.- 4.1.4 Six Weeks: Embryonic Structures, Viability.- 4.1.5 Seven Weeks.- 4.1.6 Eight Weeks: Yolk Sac.- 4.1.7 Nine to Eleven Weeks: Biometry, Embryo fetal Structures.- References.- 4.2 Abnormalities in the First Trimester.- 4.2.1 Blighted Ovum.- 4.2.2 Missed Abortion.- 4.2.3 Hydatidiform Mole.- 4.3 Ectopic Pregnancy.- 4.3.1 Detection of an Intact Intrauterine Pregnancy.- 4.3.2 Demonstration of an Intact Ectopic Pregnancy in the Cul-de-Sac or Adnexal Region.- 4.3.3 Complex Adnexal Masses.- 4.3.4 Fluid in the Abdomen or Cul-de-Sac.- 4.3.5 Principal Sources of Misdiagnosis in Patients with a Positive Pregnancy Test, No Visible Gestational Sac, and Suspected Ectopic Pregnancy.- References.- 4.4 Tumors Associated with Pregnancy.- References.- 4.5 The Kidney in Pregnancy.- References.- 5 Multiple Pregnancy.- References.- 6 Amniocentesis.- References.- 7 Normal Fetal Anatomy in the Second and Third Trimesters.- 7.1 Examination Procedure.- 7.1.1 Face.- 7.1.2 Brain.- 7.1.3 Spine.- 7.1.4 Thorax.- 7.1.5 Abdomen.- 7.1.6 Urogenital Tract.- 7.1.7 Genitalia.- 7.1.8 Extremities.- References.- 7.2 Ultrasound Biometry in the Second and Third Trimester.- 7.2.1 Introduction.- 7.2.2 Ultrasound Cephalometry.- 7.2.3 Fetal Trunk Measurements.- 7.2.4 Measurement of the Fetal Extremities.- References.- 7.3 Diagnosis of Intrauterine Growth Retardation.- 7.3.1 Diagnostic Criteria, Possible Screening Methods.- 7.3.2 Technique and Accuracy of Measurement.- References.- 7.4 Estimation of Fetal Weight.- References.- 7.5 Critical Reading of the Biometry Literature.- 7.5.1 Importance of a Critical Approach.- 7.5.2 Why Fetal Biometry.- 7.5.3 How are Normal Values Derived.- 7.5.4 Selection of the Patients.- 7.5.5 Type of Studies: Cross-Sectional or Longitudinal.- 7.5.6 Sample Size.- 7.5.7 Study Design.- 7.5.8 Curve Fitting.- 7.5.9 What is the Basic Idea of Regression Analysis?.- 7.5.10 Linear Regression Analysis.- 7.5.11 Polynomial Regression Analysis.- 7.5.12 The Coefficients of Correlation and of Determination.- 7.5.13 The F Test.- 7.5.14 Prediction from Equations.- 7.5.15 How to Compute the Confidence Limits.- 7.5.16 Summary.- References.- 7.6 Estimation of Gestational Age.- 7.6.1 Definitions.- 7.6.2 Parameters Proposed for Estimation of Gestational Age.- 7.6.3 Selection of Appropriate Table.- 7.6.4 What to Do When Different Parameters Provide Different Estimates.- 7.6.5 How to Report the Results.- 7.6.6 The Use of Computers for the Reporting of Obstetrical Examinations.- References.- 7.7 Normal Growth of Fetal Parameters.- 7.7.1 Crown-Rump Length.- 7.7.2 Cranial Parameters.- 7.7.3 Thoracic and Abdominal Organs.- 7.7.4 Long Bones.- 7.7.5 Estimated Fetal Weight.- References.- 8 Fetal Malformations.- 8.1 Signs Suggesting the Presence of a Malformation.- References.- 8.2 Neural Tube Defects.- 8.2.1 Anencephaly.- 8.2.2 Spina Bifida.- 8.2.3 Encephalocele.- References.- 8.3 Malformations of the Brain.- 8.3.1 Hydrocephalus.- 8.3.2 Microcephaly.- References.- 8.4 Malformations Involving the Abdomen and Gastrointestinal Tract.- 8.4.1 Abdominal Wall Defects.- 8.4.2 Intraabdominal Structural Abnormalities.- References.- 8.5 Malformations of the Urogenital Tract.- 8.5.1 Potter's Syndrome (Renal Agenesis).- 8.5.2 Cystic Kidneys (Potter Type I).- 8.5.3 Cystic Kidneys (Potter Type II).- 8.5.4 Cystic Kidneys (Potter Type III).- 8.5.5 Urinary Tract Obstruction.- References.- 8.6 Skeletal Malformations.- 8.6.1 Radial Aplasia.- 8.6.2 Malformations Incompatible with Postnatal Viability.- References.- 8.7 Tumors.- 8.7.1 Teratomas.- 8.7.2 Pulmonary Tumors.- References.- 8.8 Heart Defects and Cardiovascular Diseases.- 8.8.1 Cardiovascular Disease.- 8.8.2 Heart Disease.- References.- 8.9 Ultrasound Evaluation of Patients at Risk of Fetal Anomalies.- 8.9.1 High-Risk Group 1: Family History of Malformations.- 8.9.2 High-Risk Group 2: Exposure to Exogenous, Potentially Teratogenic Agents in Early Pregnancy.- 8.9.3 High-Risk Group 3: Maternal Diabetes Mellitus.- 8.9.4 High-Risk Group 4: Elevation of Serum or Amniotic Fluid AFP.- References.- 9 Rhesus Incompatibility and Nonimmunologic Hydrops Fetalis.- 9.1 Rh Incompatibility.- 9.1.1 Definition and Pathogenetic Principle.- 9.1.2 Diagnosis and Management.- References.- 9.2 Nonimmunologic Hydrops Fetalis.- 9.2.1 Etiology and Pathogenesis.- 9.2.2 Diagnosis and Treatment.- References.- 10 Phenotype and Rare Syndromes.- References.- 11 The Placenta.- 11.1 Sonographic Placental Development.- 11.2 Localization of the Placenta.- 11.3 Evaluation of Placental Growth.- 11.3.1 Placental Thickness.- 11.3.2 Placental Attachment Area, Surface Area, and Volume.- 11.4 Ultrasound Structure of the Placenta.- References.- 12 The Cervix.- References.- 13 Postpartum Ultrasound.- References.- 14 Ultrasound Screening.- 14.1 The Multistage Concept.- 14.2 Ultrasound Anatomy.- 14.3 Diagnosis of Fetal Malformations.- 14.4 Determination of Gestational Age, Growth Monitoring, and Weight Assessment.- 14.4.1 Gestational Age.- 14.4.2 Growth Monitoring and Weight Assessment.- References.- 14.5 Patterns of Fetal Activity and Their Relevance for the Assessment of Fetal Wellbeing.- 14.5.1 Patterns of Fetal Activity in Normal Pregnancy.- 14.5.2 Patterns of Fetal Activity in Complicated Pregnancy.- 14.5.3 Summary.- References.- 14.6 The Psychological Impact of Ultrasound Scanning in Pregnancy.- References.- 14.7 Conclusions.- 15 Sonographic Aspects of the Menstrual Cycle.- 15.1 Endometrium, Follicles, Blood Vessels.- 15.1.1 Endometrial Changes.- 15.1.2 Follicular Growth.- 15.1.3 Intrafollicular Structures.- 15.1.4 Bloodvessels.- References.- 15.2 Applications of Ultrasound in Endocrinology.- 15.2.1 Monitoring of Gonadotropin Therapy.- 15.2.2 Monitoring of Clomiphene Citrate Therapy.- 15.2.3 Oocyte Collection for In Vitro Fertilization.- 15.2.4 Timing the Postcoital Test.- 15.2.5 Luteal Phase Defects.- References.- 16 Pathology of the Genital Tract.- 16.1 Capabilities and Limitations of Sonographic Diagnosis.- References.- 16.2 Applications of Ultrasound in Oncology.- References.- 17 Intrauterine Contraceptive Devices.- References.- 18 Diagnosis of Breast Disease.- 18.1 Normal Structures.- 18.2 Pathologic Structures.- 18.2.1 Duct Ectasia.- 18.2.2 Cysts.- 18.2.3 Acoustic Shadowing.- 18.2.4 Fibroadenomas.- 18.2.5 Carcinomas.- 18.2.6 Mastopathies.- 18.2.7 Mastitis.- 18.2.8 Implants.- 18.2.9 Gynecomastia.- 18.3 Real-Time Scans.- 18.4 Conclusions.- References.- 19 Appendix.- A Simple Reporting Program for Obstetrical Ultrasound.

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Ultrasound diagnosis in obstetrics and gynecology

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