J. Y. Min

Diameter of the normal fetal thymus on ultrasound

To present the normative data of the transverse diameter of the developing fetal thymus.

Prenatal Ultrasound Findings of Fetal Neoplasms

A variety of neoplasms can develop in each tetal organ. Most fetal neoplasms can be detected by careful prenatal ultrasonographic examination. Some neoplosms show specific ultrasonographic findings suggesting the differential diagnosis, but others do not. Knowledge of the presence of a neoplasm in the fetus may alter the prenatal management of a pregnancy and the mode of delivery, and facilitates immediate postnatal treatment. During the last five years, we experienced 32 cases of fetal neoplasms in a variety of organs. We describe their typical ultrasonographic findings with correlating postnatal CT, MRI, and pathologic findings.

Arrangement of the systemic and pulmonary venous components of the atrial chambers in hearts with isomeric atrial appendages

BACKGROUND The morphological definition of atrial chambers, and the determination of atrial laterality, are based on analysis of the structure of the atrial appendages. The systemic and pulmonary venous connections to the heart, nonetheless, are important in the management of patients having isomeric appendages. In this study, therefore, we analysed the morphology of the postero-superior walls of the atrial chambers so as to provide evidence concerning the morphogenetic background of those hearts, and to improve operative management. METHODS We reviewed 15 autopsied specimens with isomeric right appendages, and 10 with isomeric left appendages, paying particular attention to the morphology of the systemic and pulmonary venous connections. The postero-superior walls of the atrial chambers can be made up of the atrial body, the systemic venous components, or the pulmonary venous component. We analysed the contributions made by each of these components. RESULTS The postero-superior walls of the atrial chambers were markedly variable, but could be grouped into five patterns. Bilaterally well-developed systemic venous components and absence of the pulmonary venous component within the hypoplastic atrial body were present in 9 hearts with extracardiac pulmonary venous connections in the setting of right isomerism. Bilaterally well-developed systemic venous components, and a hypoplastic pulmonary venous component within the hypoplastic atrial body, were present in 5 hearts with intracardiac pulmonary venous connections in right isomerism. Bilaterally well-developed systemic venous components, and a hypoplastic pulmonary venous component within the sizable atrial body, were present in 1 heart with an intracardiac pulmonary venous connection in right isomerism. A well-developed pulmonary venous component within the atrial body, and hypoplasia of one systemic venous component, were present in 7 hearts with left isomerism. A well-developed pulmonary venous component within the atrial body, and hypoplasia of bilateral systemic venous components, were present in 3 hearts with left isomerism. CONCLUSIONS The postero-superior walls of the atrial chambers in hearts with isomeric atrial appendages can be analysed on the basis of a compound structure made of bilateral systemic venous components, a central pulmonary venous component, and the body of the atrium. Hearts with isomeric right appendages have absence or hypoplasia of the pulmonary venous component, while hearts with isomeric left appendages have hypoplastic systemic venous components.

Complications arising in twin pregnancy: findings of prenatal ultrasonography.

Multifetal gestations are high-risk pregnancies involving higher perinatal morbidity and mortality, and are subject to unique complications including twin oligohydramnios-polyhydramnios sequence, twin-to-twin transfusion syndrome, acardiac twins, conjoined twins, co-twin demise, and heterotopic pregnancies. The purpose of this study is to describe the prenatal ultrasonographic and pathologic findings of these complications.

Fetal Musculoskeletal Malformations with a Poor Outcome: Ultrasonographic, Pathologic, and Radiographic Findings

The early and accurate antenatal diagnosis of fetal musculoskeletal malfomations with a poor outcome has important implications for the management of a pregnancy. Careful ultrasonographic examination of a fetus helps detect such anomalies, and a number of characteristic features may suggest possible differential diagnoses. During the last five years, we have encountered 39 cases of such anomalies, and the typical prenatal ultrasonographic and pathologic findings of a number of those are described in this article.

P02.68: Various prenatal sonographic findings of normal and abnormal fetal genitalia

regression of the lesion. As it regards the other 9 cases, 4 cases with cyst diameter less than 5cm were aspirated in utero. Progressive decrease in size and subsequent prenatal or postnatal regression was observed. The remaining 5 cases were submitted to postnatal operative laparoscopy. 1 case among those treated in utero underwent premature rupture of membranes and 1 case showed preterm labor. Conclusion: Many complications associated with fetal and neonatal ovarian cysts have been reported, including gastrointestinal obstruction or perforation, ascites, polyhydramnios, cyst rupture, hemorrhage and torsion. Nevertheless, in utero procedures, make the patients at risk of rupture of membranes, bleeding, intrauterine infection and premature labor. Criteria for management are still debated. A controversial about conservative versus surgical therapy remains. Therapeutic approach should be personalized in order to considered gestational age, size of the cyst, the presence of complications. These considerations will be extensively discussed.

P04.20: Pre & postnatal imaging findings of fetal neoplasms

by conventional 2D ultrasound, it was confirmed by another senior sonographer. 3D color and power Doppler were applied to delineate vascular anatomy of this area subsequently. Confirmation of antenatal diagnosis was made in all newborns. Results: Four fetuses with PRUV were detected in these 1067 cases. The estimate incidence is about 0.375% (1 : 267). Ductus venosus were found in all of the fetuses. All of them had no other additional malformation. Discussion: The diagnosis of persistent right umbilical vein was easily made in a transverse section of the fetal abdomen with ultrasound findings of the portal vein towards to the stomach and fetal gallbladder located medially to the umbilical vein by twodimensional sonography. The incidence of PRUV in our patients was similar to other articles. Reconstruction of portal system in fetus with PRUV by 3-dimensional ultrasound was easy to delineate the vascular anatomy of this area. We proposed this modality can be used to help to understand the vascular anatomy of the fetus with PRUV.

P04.21: Broad spectrum of ultrasound (US) findings of hydatidiform mole and molar mimicker

by conventional 2D ultrasound, it was confirmed by another senior sonographer. 3D color and power Doppler were applied to delineate vascular anatomy of this area subsequently. Confirmation of antenatal diagnosis was made in all newborns. Results: Four fetuses with PRUV were detected in these 1067 cases. The estimate incidence is about 0.375% (1 : 267). Ductus venosus were found in all of the fetuses. All of them had no other additional malformation. Discussion: The diagnosis of persistent right umbilical vein was easily made in a transverse section of the fetal abdomen with ultrasound findings of the portal vein towards to the stomach and fetal gallbladder located medially to the umbilical vein by twodimensional sonography. The incidence of PRUV in our patients was similar to other articles. Reconstruction of portal system in fetus with PRUV by 3-dimensional ultrasound was easy to delineate the vascular anatomy of this area. We proposed this modality can be used to help to understand the vascular anatomy of the fetus with PRUV.

OC24.07: Usefulness of measurement of the fetal thymus in the diagnosis of IUGR: a preliminary result

Comment: In CHD fetuses, increased DV Index, associated with reduced forward ductal flow to the right atrium, well correlates with increased right atrial pressure occurring in right outflow tract obstruction or in hypoplastic left ventricle. On the contrary in IUGR fetuses with increased DV Index and compensatory ductal dilatation, normal left cardiac output suggests normal myocardial function due to a maintained or even increased forward flow through the DV to right atrium.

OC8.01: Ultrasound measurement of the transverse diameter of the fetal thymus

26 Profuse vaginal bleeding Selective embolization No Pregnancy, Recurrent AVM (40 m) 34 Prolonged vaginal spotting Hysterectomy No Cure (32) 29 Prolonged vaginal spotting Follow-up Yes AVM not identified in follow-up scans (26 m) 16 GTS-resistant to chemotherapy Multi-agent chemotherapy Yes Persistent AVM despite negative beta-HCG (30 m) 27 GTS-resistant to chemotherapy Hysterectomy Yes Cure (24 m) 31 Postpartum hemorrhage-severe Observation No AVM not identified in follow-up scans (22 m) 28 Postpartum hemorrhage-severe Selective embolization No AVM not identified in follow-up scans (18 m)