0693: Ultrasound for Right Iliac Fossa Pain

Abstracts The grey scale findings could include distended bowel loops, free peritoneal fluid with internal echoes or focal bowel wall thickening. We have seen patients presenting with infarcts in the liver and spleen on grey scale. Patients with acute mesenteric ischemia can also present to the sonologist with air in the portal radicles, intestinal walls and in the peritoneal cavity. Colour Doppler findings in acute mesenteric ischemia are variable -including difficulty in evaluating the vessels, demonstration of actual thrombus in mesenteric artery or vein to vaso-spastic SMA. In chronic mesenteric ischemia, colour Doppler offers more definitve diagnosis. It is also useful in evaluating these patients after invasive procedures. A spectrum of grey scale and colour Doppler findings in acute and chronic mesenteric ischemia are presented in this talk.

0693 Ultrasound for Right Iliac Fossa Pain Norbert Gritzmann, President of EFSUMB, Austria The painful right lower quadrant is a challange for interdisciplinary sonography. Especially in clinical doubtful cases sonography is used to establish the diagnosis of acute appendicitis.The sonographic signs of the normal and the pathologic appendix will be presented. The main differential diagnosis regarding the intestinal tract will be assessed.(infectious diseases,Crohn⬘s disease or right sided diverticulitis,intususception). Peritoenal diseases as appendangitis,rectus wall haematoma or psoas haematoma will be discussed.The sonographic assessment of ureterolithiasis, including transrectal sonography is presented.The main gynecological differentialdiagnoses will be presented from the transabdominal approach.Sonograhy proved to be a valuable first linie modality for the assessment of the painful right lower quadrant.

0696 The Prognosis of Monochorionic Twin with Selective Intra Uterine Growth Restriction with Different Types on Umbilical Artery Doppler of the Restricted Twin Yao-Lung Chang, Chang Gung University College of Medicine, Taiwan Obsject: To evaluate the clinical outcome in monochorionic diamniotic twin pregnancies and selective intrauterine growth restrictions (sIUGR) with different types of umbilical artery (UA) Doppler. Material and Methods: An monochorionic diamniotic twin pregnancy with sIUGR was defined as a fetal weight below the 10th percentile in one twin. monochorionic diamniotic twins were divided into three groups: without IUGR (group I); with sIUGR, and a normal UA Doppler (group II); or an abnormal UA Doppler (persistent absence or reverse of end-diastolic velocity) (group III). Result: Altogether, 27 cases of group I, 11 cases of group II and 13 cases of group III monochorionic diamniotic twins were included. There was incidence of neonatal death in six (6/26) of group III monochorionic diamniotic fetuses, while none in groups I and II MCDA twins did. Conclusions: In monochorionic diamniotic twins with sIUGR, abnormal UA Doppler in the IUGR twin may face poorer neonatal outcomes. The prognosis of group II monochorionic diamniotic twins, even with sIUGR found in early gestation, is, by contrast, better.

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0698 Fetoscopic Guided Laser Therapy for Twin-to-Twin Transfusion Syndrome: Taiwan Experience Yao-Lung Chang, Chang Gung University College of Medicine, Taiwan Purpose: In order to assess the outcome of pregnancies complicated by severe twin-twin transfusion syndrome (TTTS) undergoing treatment with endoscopic laser surgery in Taiwan. Methods: Patients presenting with monochorionic-diamniotic twin pregnancies complicated by severe TTTS before 26 weeks of gestation and received endoscopic laser surgery to coagulate placental vascular anastomoses were included. The perinatal outcomes were reported. Result: From October 2005 to March 2009, 31 consecutive cases of severe TTTS were operated .Overall, both twins were born alive in 11 cases (only one twin was born alive in 14, and neither was born alive in the remaining 7. Therefore, 78.1 % (25 of 32) of the pregnancies resulted in at least one liveborn infant. Of the 36 surviving babies, 3 (8.3%) babies show evidence of severe neurological sequence with periventricular leukomalacia detected by MRI examination. Conclusions: This preliminary experience suggests that selective laser coagulation appears to be a good treatment for severe TTTS. 0700 Clinical Significance of Dilated Lactiferous Ducts Yi-Hong Chou, Department of Radiology, Veterans General Hospital-Taipei, Taiwan See-Ying Chiou, Department of Radiology, West Garden Hospital, Taiwan Hong-Jen Chiou, Department of Radiology, Veterans General Hospital-Taipei, Taiwan Chui-Mei Tiu, Department of Radiology, Veterans General HospitalTaipei, Taiwan Chih-Yi Hsu, Taipei Veterans General Hospital and National YangMing University, Taiwan Chung-Ru Lai, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan Hui-Ru Chiang, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan Siew-Peng Chen, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan Hsin-Kai Wang, Department of Radiology, Veterans General Hospital-Taipei, Taiwan Chao-Shuen Yen, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan Cheng-Yen Chang, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan Purpose: To prospectively evaluate the clinical significance of ductal dilatation detected at breast ultrasonography (US) study by using high-resolution US (HRUS) machines. Methods: During a period of 12 months, we examined 16,336 nonlactating women referred for breast US (about 2.5% of them had known history of nipple discharge). Routine whole breast US examinations were performed by using HRUS. Among these, 478 patients (2.9%) had duct dilatation (defined as a diameter greater than 2.0mm). Patients with dilated ducts were either followed up for at least 2 years or were aspirated or biopsied according to the US findings. Results: 387 women showed no significant internal echoes in the dilated ducts (80.9%). Low-level internal echoes inside the ducts were noted in 48 women (10%) and medium-level to relatively high-level internal echoes in 39 women (8.1%); among these, solid nodules in the