Echocardiographic Anatomy in the Fetus (eBook)

Preface 6
Preface 7
Acknowledgements 9
Contents 11
Part I Basic Principles of Diagnosis 16
1 General Guidelines 17
Introduction 17
Equipment 18
Major Planes of the Body and Heart 20
Basic Probe Manipulations 21
Axial and Lateral Resolution 23
Method for Comprehensive Cardiac Evaluation 24
References 26
2 Determining the Laterality of the Fetal Body and Image Orientation 29
Introduction 29
Methods 30
Image Orientation 33
Reference 34
3 The Visceroatrial Arrangement (Situs) 35
Introduction 35
Usual Arrangement (Situs Solitus) 35
Mirror-Image Arrangement (Situs Inversus) 37
Left Isomerism (Polysplenia) 38
Right Isomerism (Asplenia) 40
References 42
4 The Cardiac Position and Axis Orientation 43
Introduction 43
Heart in the Left Side of the Chest (Levocardia) 44
Isomerism of the Atrial Appendages and Cardiac Position 49
References 51
5 Principles of Segmental Analysis 52
Introduction 52
The Atria 52
The Ventricles 53
The Arterial Trunks 55
The Atrioventricular Connection 55
The Ventriculoarterial Connection 57
References 61
Part II Echocardiographic Projections - A Transverse Views of the Fetal Body 62
6 The Transverse Views of the Upper Abdomen 63
Introduction 63
The Umbilical Cord Insertion 63
The Lower Liver 64
The Mid Liver 64
The Portal Sinus 64
The Infracardiac Vena Cava 67
The Suprahepatic Veins 67
References 69
7 The Four-Chamber View 70
The Section Plane 70
The Normal Morphology 70
The Normal Echocardiogram – 2D 71
Dimensions of the Heart 74
Measurement 74
Ventricular Function 76
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 76
Four-Chamber-View Checklist 83
References 85
8 The Five-Chamber View 87
The Section Plane 87
The Normal Morphology 87
The Normal Echocardiogram – 2D 87
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 89
References 96
9 The Three-Vessel View 97
Introduction 97
The Normal Morphology 97
The Normal Echocardiogram – 2D 98
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 98
Three-Vessel-View Abnormalities 99
Ascending Aorta and Pulmonary Artery Disproportion 106
Aortic Arch Sidedness 106
Relationship of the Great Arteries and Cardiac Connections 106
References 109
10 The Arterial Duct Transverse View 110
The Section Plane 110
The Normal Morphology 110
The Normal Echocardiogram – 2D 111
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 111
The Arterial Duct – Reversed Flow 112
The Arterial Duct – Short Length 114
The Arterial Duct – Abnormal Shape 114
The Arterial Duct – Premature Constriction or Closure 117
The Arterial Duct – Abnormal Position 119
References 120
11 The Aortic Arch Transverse View 121
The Section Plane 121
The Normal Morphology 121
The Normal Echocardiogram – 2D 121
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 123
Aortic Arch Abnormal Size 124
Aortic Arch Interruption 125
Aortic Arch Sidedness 125
References 129
12 The Arterial Duct and Aortic Arch Transverse View 130
The Section Plane 130
The Normal Morphology 130
The Normal Echocardiogram – 2D 130
The Normal Echocardiogram – Color Flow Mapping 131
The Aortic Arch Abnormalities 133
Azygos Vein Dilatation 135
The Transverse Views of the Fetal Body: an Overview 136
References 138
Part II Echocardiographic Projections - B Longitudinal Views of the Fetal Body 140
13 The Inferior and Superior Vena Cava Long-Axis View (The Bicaval View) 141
The Section Plane 141
The Normal Morphology 141
The Normal Echocardiogram – 2D 143
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 143
The Azygos Vein 145
Vena Cava Disproportion 145
Azygos Vein Dilatation 145
References 148
14 The Aortic Arch Long-Axis View 149
The Section Plane 149
The Normal Morphology 149
The Normal Echocardiogram – 2D 151
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 152
The Aortic Arch Abnormalities 154
References 159
15 The Arterial Duct Long-Axis View 160
The Section Plane 160
The Normal Morphology 160
The Normal Echocardiogram – 2D 161
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 162
Duct-Dependent Systemic Circulation 164
Duct-Dependent Pulmonary Circulation 164
The Arterial Duct – Premature Constriction or Closure 167
References 169
16 Special Considerations on the Arterial Duct and Aortic Arch Views 170
Technique 170
17 The Right Ventricle Outflow View 174
The Section Plane 174
The Normal Morphology 174
The Normal Echocardiogram – 2D 176
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 176
18 The Left Ventricle Short-Axis View 182
The Section Plane 182
The Normal Morphology 182
Part II Echocardiographic Projections - C Oblique Views of the Fetal Body 189
19 The Left Ventricle Long-Axis View 190
The Section Plane 190
The Normal Morphology 190
The Normal Echocardiogram – 2D 192
The Normal Echocardiogram – Color Flow Mapping and Pulsed Doppler 192
Part III Echocardiographic and Morpologic Overview 199
20 Three-Dimensional Ultrasound Assessment of the Fetal Heart 200
Introduction 200
Technical Principles of 3D/4D Fetal Echocardiography 200
Conclusion 209
References 211
21 The Role of the Pathologist in the Diagnosis of Fetal Heart Disease 212
Introduction 212
The Morphologic Study 212
New Technique for the Autopsy 217
Description of Cardiovascular Defects 218
Iconographic Documentation 218
Conclusion 221
References 222
Credits for Figures 223
Credits for Figures - DVD 223