2061655 Ultrasound Measurements of Renal Volume Among Nigerian Population

Abstracts 2060741 Through the Looking Glass: Ultrasound Imaging in the classroom to teach invivo Anatomy and Kinesiological Principles to first year Doctor of Physical Therapy students Ruth Maher, Sheri Hale Physical Therapy, Shenandoah University, Stephenson, VA, United States Objectives: To examine the effects of musculoskeletal ultrasound (MSK-US) demonstrations on students in-class experience and understanding of anatomy and kinesiological principles. Methods: A faculty member with MSK-US experience oriented students and identified structures. One demonstration covered the abdomino and lumbo-pelvic regions with students observing the superficial and deep abdominal muscles, mulitifidii, pelvic floor muscles, bladder and fascia at rest, during sit ups, core stability exercises, pelvic floor exercises, coughing, laughing and valsalva. A second demonstration observed the joint slide/glide associated with joint mobilizations which was quantified using on screen calipers. Students completed questionnaires anonymously via an online survey builder. A 5-point Likert scale graded responses which ranged from 5 (strongly agree) to 1 (strongly disagree). Results: 100% of respondents (79% response rate) agreed that MSK-US stimulated their interest, in addition to improving their knowledge and understanding. Furthermore, they gained a clinical perspective and synthesized what they were learning. Comments were extremely positive and included the following: MSK-US brought lecture to life.. added the missing piece of seeing and understanding’’, ‘‘ it’s one thing to be told what’s going on, another thing entirely to see it happen’’, ‘‘seeing.. inside the body’’, ‘‘it was beneficial to see the amount the shoulder moves during joint mobilizations and this is something I didn’t quite understand before the demonstration’’, ‘‘I liked that it was interactive’’ and ‘‘being able to visualize the difficulty in controlling pelvic floor and abdominal muscles’’. Conclusions: MSK-US is an invaluable and novel tool to use in the classroom. It provides real time static and dynamic views regarding how manual techniques and other factors such as posture, adipose and activities can affect muscle and joint function. It brings anatomy to life and underlines the clinical relevance of why the students are learning it. Students embrace it and are actively engaged in the classroom. Clearly ultrasound has applications beyond those of routine diagnoses.

2060747 Accuracy of Ultrasound in Fetal Birth Weight Estimation in Term Pregnancies Sadisu Maaji, Radiology, FMC BIRNIN KEBBI, Birnin Kebbi, Birnin Kebbi, Nigeria Objectives: The aim of this study is to determine the the accuracy of fetal birth weight estimation using ultrasonography Methods: This was a prospective study involving 109 singleton uncomplicated pregnancies. Inclusion criteria in the study were term pregnancy (36 to 42 weeks). Patients with malpresentation, gestational diabetes, pulmonary tuberculosis, multiple pregnancy were excluded. All examinations were performed using a Dynamic Imaging Concept D real time ultrasound machine with a 3.5 MHz curvilinear transducer. Measurements were made with calibrated caliper on the machine on frozen images. Data analysis was performed using SPSS 17.0 statistical soft ware after collation of data. Results: The mean maternal age was 2.246SD0.58 (range 20-40). The mean actual birth weight within the study cohort was 2.026SD0.49 (range of 2500-4000g).Twelve (10.7%) infants weighed less than 2500 g, and 83 (74.1%) weighed more than 2600 to 4000 g. Of the 109 14(12.5%) weighed more than 4500g.The mean estimated fetal weight was 2.026SD0.49 (range of 2500-4500g).The mean estimated

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gestation age was 1.996SD0.166 (range 30-45). Table 3 show an overestimation of the fetal birth weight in 39.3%, while underestimation was seen in 53.6% of the fetuses. The accurate birth weight was seen in only 4.5% of the fetuses. Conclusions: There was significant error seen while estimating fetal weight by ultrasound and underestimation has the highest percentage. However for accurate detection of fetal weight scan delivery interval is the most important factor. Depending only on the fetal ultrasound for the estimation of fetal weight can lead to unnecessary obstetrical intervention.

Error Estimation Characteristics (Estimate) Number(percentage) 1.Overestimate 2.Underestimate 3.Accurate

44(39.3%) 60(53.6%) 5(4.5%)

2061652 Hepatic Size in Patients With Chronic Liver Disease Among Nigerian Population: The Sokoto Experience Sadisu Maaji,1 1 Radiology, UDUTH, Sokoto, Sokoto, Nigeria Objectives: The OBJECTIVES: of this study was to establish hepatic size in patients with clinical suspicion of chronic liver disease among Nigerian population. Methods: The study was carried out at the Gastroenterology unit of the department of Radiology Usmanu Danfodiyo University Teaching Hospital(UDUTH) Sokoto, Nigeria Approval for the study was obtained from the Ethics and Research committee of the UDUTH. A total of 61 patients with an initial diagnosis of CLD that were referred to the Radiology clinic were recruited. Results: A total of 61 abdominal ultrasounds were performed during this study period. All the cases met the inclusion criteria. The mean age was (46.0612.6) years (ranged 50 years).The mean liver size was (13.2561.48) cm (ranged 11 cm) and (14.00 60.77) cm (ranged 0.77 cm) for right and left lobe respectively. The Peak age of the patients was 50 years. Conclusions: The hepatic size among patients with chronic liver disease was documented Ultrasound is useful in the diagnosis of chronic liver disease in daily clinical practice. However, the sensitivity can be improved if a high frequency probe is used and done by experienced and dedicated operators.

2061655 Ultrasound Measurements of Renal Volume Among Nigerian Population Sadisu Maaji, Radiology, UDUTH, Sokoto, Sokoto, Nigeria Objectives: The aim of this study was to establish normal renal volume among our Nigerian population. Methods: All the patient’s blood pressure, serum creatinine and fasting blood sugar ware within normal range. There were 80 females and 24 males. Before proceeding to ultrasound scanning, the procedure was explained to the respondents and their consent obtained.All renal scans were done by using a single real-time Dynamic Ultrasound scanner using a 3.5-MHZ curvilinear probe. Hard copy images were taken for documentations and all the scans were done by a trained radiologist to avoid inter and intra observer variability. The renal volume of both kidneys was automatically generated by the machine using ellipsoid formula. Results: The mean age was 30.46SD19 years (18-70).The renal volume was 109.66SD29.3 and 119.76SD32.8 for right and left kidney

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respectively. The body mass index was calculated to be 25.66SD4.72. Renal measurements were correlated with the subject’s height, weight, body mass index using the Pearson’s correlation. The strongest correlation with renal volume an age, the correlation coefficient was 0.997 (p,0.001). The subjects height correlates well with body mass index with correlation coefficient of 0.320 (p,0.001). Conclusions: We established valuable normal values of renal volumes in our adult Nigerian population. The weight, height body mass index were also taken into consideration with positive correlations between renal volume and age as well as height and body mass index. The study was done with one ultrasound machine to avoid a false-Negative findings We recommend a multicenter study so that we can document a gender and age specific normal renal dimensions for adequate comparison in evaluation of renal diseases.

Results: 209 singleton fetuses with a hypoplastic umbilical artery were identified. 29 (13.9%) had cardiac abnormalities and overall 49 (23.4%) were anomalous. 14 (6.7%), all anomalous, had abnormal karyotypes, including 8 with cardiac findings. Of the 29, only 2 were not identified antenatally: one had VSD and ASD; the other had pulmonary stenosis. Sensitivity, specificity, positive predictive value and negative predictive value for CHD were 93.1%, 100%, 100% and 98.9%. Conclusions: CHD is frequent when hypoplastic umbilical artery is present. Most cardiac abnormalities were detected by standard 4 chamber view and evaluation of outflow tracts by meternal fetal medicine specialists. Universal referral to pediatric cardiology may not be necessary. Referral, however, may still be appropriate for other indications, such as thiose with unsatisfactory imaging, positive family history, in inadequately controlled diabetics.

2062260 Placenta Accreta Detection: Use of Ultrasound and Mri In An at Risk Population Paula Barcia, Karen Koscica, Munir Nazir, Martin Gimovsky Obstetrics and Gynecology, Newark Beth Israel Medical Center, Newark, NJ, United States

2062511 High-Frequency Ultrasound Examination of The Deep Cervical Artery E. Zhansen, Ultrasound, Longgang District Central Hospital of Shenzhen, Shenzhen, Guangdong, China

Objectives: To evaluate the use of ultrasound and MRI to diagnose placenta accreta in an at risk population. Methods: Data on 23 women with multiple risk factors for placenta accreta was prospectively obtained. Placental mapping by ultrasound was followed by MRI to refine the diagnosis. The diagnosis of placenta accreta(including both increta and percreta) was confirmed histologically. Results: 13/23 women had placenta accreta(57%). 7/23 had both a positive ultrasound and MRI; 6/7 of these pregnancies(84%) had confirmed placenta accreta. 9/23(39%) had a positive scan and a negative MRI; 6/9 (67%) had conformed placenta accreta.16/23(70%) of women with a positive ultrasound independent of MRI had confirmed placenta accreta. When ultrasopund and MRI were negative 6/7(84%) women did not have confimed placenta accreta. Conclusions: A careful history identified placenta accreta in more than half of placenta accreta confirmed pregnancies(13/23,57%). The adjunctive use of ultrasound incresaed he finding of confirmed placenta accreta to 75% (12/16). The addition of a positive MRI further increased this ito 84% (6/7).a negative ultrasound and a negative MRI were able to exclude the diagnosis of placenta accreta in 84% (6/7) of pregnancies. A thorough history and ultrasound should be performed in women with multiple risk factors for placenta accreta. If ultrasound is negative, the use of MRI may further ocntribute to excluding the diagnosis.

Objectives: To identify the high frequency ultrasonic ultrasonographic characteristics of the the deep cervical artery in the neck and nuchal. Methods: Application of the high-frequency ultrasonic scan the deep cervical artery following anatomy traveling in the supraclavicular fossa and nuchal. Results: 3.1 The probe is placed inside the supraclavicular fossa,displaying the sonographic of the minor axis of the subclavian artery and the medial segment of long axis of the deep cervical artery in the neck,the latter came from the posterior wall of the subclavian artery and traveled to the rear of the middle scalene muscle. 3.2 Continue to scan towards the back, displaying sonographic of lateral segment of long axis of the deep cervical artery in the neck, which crossed the clearance between the middle scalene muscle and the posterior scalene muscle under the seventh cervical vertebra transverse process to the nuchal. 3.3 Place the probe in right side of the nuchal midline and transect at the level of the fifth cervical spinous process, displaying the color ultrasonography of minor axis of the deep cervical artery, which was located in the deep side of the semispinalis capitis muscle and the outside of semispinalis cervicis muscle, multifidus muscle and rotatores muscle. 3.4 The probe chamfered downward the outside on the basis of the results 3 section, displaying sonographic of lateral segment of the deep cervical artery in the nuchal, which walked in the deep side of the longus cervicis muscle and the llocostalis cervicis muscle. 3.5 The probe rotated 90 degrees and longitudinally cutted on the basis of results 4 section ,displaying sonographic of medial segment of long axis of the deep cervical artery in the nuchal, which ran upward the lateral clearance between the semispinalis capitis muscle and the semispinalis cervicis muscle, eventually merged with the descending branch of the occipital arter. Conclusions: The deep cervical artery came from the costocervical trunk which was a branch of the second section of the subclavian artery behind the anterior scalene muscle in supraclavicular fossa, eventually merged with the descending branch of the occipital arter and participated in blood circulation of suboccipital triangle.

2062390 Hypoplastic Umbilical Artery: Is There a Need for Universal Referral for Pediatric Fetal Echocardiography? Ashley Hirsch, Asha Heard, Ashley Veade, Joseph Miller Ob-Gyn, LSUHSC, New Orleans, LA, United States Objectives: To assess the adequacy of a standard evaluation of the fetal heart (4 chamber view and outflow tracts) with ultimate fetal outcome among singleton pregnancies with a hypoplastic umbilical artery. Methods: This cohort study assessed fetuses identified antenatally with a hypoplastic umbilical artery. Studies were done between October 2005 and March 2014 thru the Louisiana State University Maternal Fetal Network. Abnormal cardiac findings prompted pediatric fetal echocardiography referral. Cord status was confirmed by pathology reports, delivery notes, or two independent observers. The presence or absence of congenital heart disease (CHD) was confirmed by newborn examination, imaging, or prosection. Undetected cardiac abnormalities are reported. Institutional Review Board approval was obtained.

2064800 Atypical Presentations Of Molar Pregnancy. Paired Diagnostic Role Of Imaging And B-HCG Measurement Sara Mohamed,1,2 Ayman Alhendy,2 Paul Browne2 1 Obstetric and Gynecology, Mansoura faculty of medecine, Mansoura, dakahleya, Egypt, 2Obstetric and Gynecology, Georgia regents university, Augusta, GA, United States