Mi Jin Song

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.

The Distribution of Fetal Nuchal Translucency Thickness in Normal Korean Fetuses

The aim of present study was to establish normative data for the distribution of nuchal translucency (NT) thickness in normal Korean fetuses. The data were collected from pregnant women with singleton pregnancies in whom fetal ultrasound was performed and the fetal NT thickness was measured between 11 and 14 weeks of gestation. Among them, a total of 2,577 fetuses with a known normal outcome were included in this study. The distribution of multiple of median (MoM) values of the NT thickness with crown-rump length (CRL) in 10-mm intervals and the 95th percentile of MoM were calculated with the linear regression method. The present study showed that NT measurements increase with increasing CRL and a false positive rate increases with increasing gestational age. Therefore, a fixed cut-off point through the first trimester was not appropriate and each NT measurement should be examined according to the gestational age. The present study offers normative data of the fetal NT thickness in a Korean population, which can be used as reference for screening chromosomal aberrations or other congenital abnormalities in the first trimester.

Multilocular Cystic Lesions in the Uterine Cervix: Broad Spectrum of Imaging Features and Pathologic Correlation

OBJECTIVE The objective of this article is to describe the broad spectrum and imaging features of multilocular cystic lesions in the uterine cervix from benign lesions, such as uterine cervicitis, endocervical hyperplasia, nabothian cyst, and tunnel cluster, to malignant lesions including adenocarcinoma and adenoma malignum. CONCLUSION Familiarity with the clinical setting and imaging features of multilocular cystic lesions in the uterine cervix can help prevent unnecessary radical surgery before histopathologic proof of malignancy and can facilitate prompt and accurate diagnosis and treatment.

Serial Transvaginal Sonographic Findings of Cervical Ectopic Pregnancy Treated With High-Dose Methotrexate

Objective. We analyzed transvaginal sonographic findings from patients with cervical ectopic pregnancies treated with high‐dose methotrexate (MTX). Methods. This was a retrospective analysis of cervical pregnancies diagnosed in our institution from 1996 through 2006. We divided the cases into an MTX treatment group and a surgical treatment group. We included cases treated with high‐dose MTX alone. We analyzed 9 cervical ectopic pregnancies treated with MTX, which was injected intravascularly at 100 mg/m2 plus 200 mg/m2 in 500 mL of a normal saline solution with folinic acid rescue. The gestational sac sizes and serum human chorionic gonadotropin (hCG) levels were periodically monitored to determine the resolution status. Results. Fifty cervical pregnancies were diagnosed during the study period. Thirty cases were treated with MTX, and 20 were treated with surgical procedures. Among the 30 cases in the MTX treatment group, 9 had high‐dose MTX injection without surgical procedures. Cervical mass regression appeared at a median of 40 (range, 10–88) days after treatment, whereas the serum hCG level decreased at a median of 14 (range, 9–17) days after treatment. The median time to complete regression of the cervical mass was 86 (range, 48–141) days, and the median time to complete regression of the serum hCG level was 68 (range, 19–143) days. Cervical pregnancy was noted as a gestational sac at first but coexisted with a mixed echoic lesion 19 days after treatment. At 33 days after treatment, the cervical pregnancy was completely replaced by the mixed echoic lesion. Conclusions. Resolution of the cervical mass on sonography lagged far behind resolution of the serum hCG level. The cervical mass evolved from a gestational sac into a mixed echoic lesion on serial transvaginal sonography.

Congenital Portosystemic Shunts Prenatal Manifestations With Postnatal Confirmation and Follow-up

The purpose of this study was to evaluate prenatal sonographic findings that could be helpful for diagnosis of congenital intrahepatic portosystemic venous shunts and the follow‐up results.

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.

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.