Myung Sook Lee

Ovarian sclerosing stromal tumors: gray scale and color Doppler sonographic findings.

Sclerosing stromal tumors are rare benign ovarian stromal tumors, which have distinctive clinical and pathologic features. The tumors occur predominantly in the second and third decades and are histologically characterized by the pseudolobular pattern of the cellular and hypocellular areas, marked vascularity, and heterogeneity of the cellular area. We analyzed 7 cases of sclerosing stromal tumors, which showed a typical sonographic appearance. On sonograms, sclerosing stromal tumors were solid and cystic and contained multiple round or cleftlike cysts. Ascites was rare. On transvaginal color Doppler sonograms, sclerosing stromal tumors were very hypervascular in the peripheral solid area and internal intercystic space and showed low‐impedance flow. We conclude that sclerosing stromal tumors should be considered in young women with menstrual irregularity who have hypervascular solid and cystic adnexal masses.

Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients

To evaluate the ultrasonographic features of adenoma malignum, a minimal deviation adenocarcinoma of the uterine cervix.

Sonographic findings of uterine cervical lymphoma manifesting as multinodular lesions

Uterine cervical lymphoma, a very rare condition, has rarely been reported in sonographic findings in the English medical literature. We describe a case of uterine cervical lymphoma which was detected initially and depicted on sonography as a multinodular smoothly lobulated heterogeneous mass with some posterior enhancements.

In Utero Development of the Fetal Gall Bladder in the Korean Population

Objective To provide reference ranges of the fetal gall bladder in the Korean population. Materials and Methods Fetal gall bladder development was evaluated in well-dated, non-anomalous fetuses in the Korean population between February and April 2003 and the visualization rate and reference values were determined from the obtained data. Results The visualization rate of the fetal gall bladder increased as gestation advanced to a plateau above 90%, which was maintained between 16 and 34 weeks. The measured parameters from the fetal gall bladder had a significant positive relationship with gestational age (p = 0.000 for all cases), and the correlation of length and area with the gestational age (r = 0.741 and r = 0.690, respectively) was better than the correlation of width, height, and volume with gestational age. The repeatability coefficients and coefficients of variation between the two operators were 5.56 mm and 12.9% for the length and 344.11 mm2 and 33.52% for the area. The median length of the fetal gall bladder in the Korean population was not significantly different from the mean length of gall bladders in the Caucasian and African-American populations (p = 0.915). Conclusion We have provided reference values for the fetal gall bladder throughout the gestation period in the Korean population.

OP16.05: Diamniotic twin pregnancies with a single placental mass; prediction of chorionicity at 11–14 weeks of gestation

Methods: We have prospectively evaluated 12.006 fetuses (10.789 single pregnancies fetuses and 1.217 multiple pregnancies fetuses) at 11–14 weeks’ gestation, between January 2000 and December 2006. The exploration was performed transvaginal or combined transvaginal/transabdominal, when necessary. We follow Fetal Medicine Foundation Guidelines for the measurement of DV. Reversed DV was analyzed according to its association with chromosomal anomalies. X2 Pearson or Fishers exact test (depending on the requirements of each test) were used for statistical analysis. When we found a significant probability value we present the OR with its 95% confidence interval. The follow up was performed with pediatric neonatal exploration or phone poll, in case of delivery in another hospital. Results: We have diagnosed 17 chromosomal abnormalities in the multiple pregnancies group (1.4%) and 135 chromosomal anomalies (1.3%) in the single pregnancies group. Detection Rate for Trisomy 13, Trisomy 18 and Trisomy 21 has been 44.4% in multiple pregnancies and 79.2% in single pregnancies. We have found a Positive Prective Value of 3.7% in the group of multiple pregnancies and of 7.7% in single pregnancies for Trisomy 13, Trisomy 18 and Trisomy 21. False Positive Rate has been 8.7% in multiple pregnancies and 6.8% in single pregnancies for Trisomy 13, Trisomy 18 and Trisomy 21. In patients older than 35 years old, the Negative Predictive Value has been of 99.3% in multiple and 99.1% in single pregnancies and the Positive Predictive Value of 4% in multiple pregnancies and 14.8% in single pregnancies for Trisomy 13, Trisomy 18 and Trisomy 21. Conclusions: DV screening has not a similar effectiveness in singles and multiple pregnancies as an early ultrasound marker for 13, 18 and 21 Trisomy.

OC104: Isolated gallbladder abnormality in utero: clinical significance as a screen for fetal anomaly

Objectives: To examine the outcome of fetuses with short femur length (FL) at the time of the routine anomaly scan. Methods: This was a retrospective review of antenatal, pediatric and genetics records of pregnancies where ultrasound measurement of FL at 18–24 weeks of gestation was found to be below the 5th centile. All pregnancies had an ultrasound at 11–13 + 6 weeks to confirm pregnancy dating and also had nuchal translucency (NT) risk assessment. Results: There were 129 fetuses over a 6-year period. In 46 (35.7%) cases short FL was associated with other structural abnormalities. In this group skeletal dysplasias (n = 16), chromosomal abnormalities (n = 10) and genetic syndromes (n = 4) were the most common associations. Short FL was classified as isolated in the remaining 83 (64.3%) cases. There were no cases of chromosomal abnormalities in this group. Eleven (13%) were false positives with FL at subsequent scans within the normal range; all of these had a normal outcome. In the remaining 72 (87%) FL measurements were consistently below the fifth centile. Early severe fetal growth restriction (FGR) with abnormal umbilical artery Doppler requiring delivery before 37 weeks of gestation occurred in 33/83 (40%); 90% of these had abnormal uterine artery Doppler at the time of presentation. This cohort was complicated by pre-eclampsia in 12/33 (36%) cases, intauterine fetal death in 11/33 (30%), while a further two suffered a neonatal death. In 39/83 cases umbilical artery Doppler remained normal; five of these patients delivered before 37 weeks owing to pre-eclampsia or placental abruption (n = 3) or spontaneous preterm labour (n = 2), while in 34 delivery occurred after 37 weeks of gestation. Conclusions: In a population previously screened by NT, isolated short FL at the time of the routine anomaly scan is not associated with chromosomal abnormalities. Severe FGR associated with high mortality occurs in 40%, making uterine artery Doppler evaluation more useful than amniocentesis in these pregnancies.