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Hands-on Obstetric Ultrasound
SPECIAL INTEREST SESSIONS 1:00 PM – 3:00 PM Contrast-Enhanced Ultrasound in Pediatrics
lupus), recent/ongoing infection, and exposure to arrhythmogenic agents (i.e., caffeine). As with fetal imaging in general, the evaluation of fetal arrhythmias should begin with a detailed, 2D (gray scale) evaluation of fetal cardiac anatomy and function, ideally including the use of color and pulsed Doppler. In many cases, the diagnosis of a fetal arrhythmia can be made with 2D and color flow imaging, alone. Commonly, however, pulsed Doppler, conventional m-mode, color m-mode and/or other techniques may improve the ability to make a precise and accurate diagnosis. The choice of which techniques to utilize depends as much on operator preference/experience as on fetal lie and arrhythmia. Once the diagnosis of a fetal arrhythmia has been made, the approach to management should consider the entirety of the fetus and pregnancy, acknowledging risks (maternal and fetal) and benefits of each therapeutic option (including observation or delivery). Care should be taken to obtain legitimate informed consent for any intervention. Happily, the vast majority of fetal arrhythmias carry an outstanding prognosis.
Moderators: Mary Beth McCarville, MD In this session, experts in pediatric contrast-enhanced ultrasound (CEUS) will discuss the current role of CEUS in the assessment of trauma, focal liver lesions, and voiding urosonography in children. The potential need for a pediatric CEUS registry and other regulatory issues will be discussed. Voding Urosonography – An Update Kassa Darge The Children’s Philadelphia Perelman School University of Pennsylvania
Hospital of of Medicine,
Contrast enhanced voiding urosonography (ceVUS) is the sonographic examination for vesicoureteric reflux (VUR). It is similar to fluoroscopic voiding cystourethrography (VCUG) and scintigraphic direct radionuclide cystography (DRNC). However, ceVUS achieves the diagnostic goal without utilization of radiation. The procedure of ceVUS encompasses bladder catheterization, administration of US contrast agent and US of the bladder and kidneys during filling and voiding. During the voiding phase a suprapubic and transperineal US of the urethra, a urethrosonography, is performed. Thus complete evaluation for vesicoureteric reflux and urethral pathology is possible. Over the past 15 years ceVUS has been increasingly employed for pediatric vesicoureteric reflux diagnosis in Europe. Different US contrast agents have been used off-label for ceVUS in children. Currently, the most widely used one is SonoVueÒ from Bracco. The ultrasound contrast agent OptisonÒ (General Electric) is now being utilized for ceVUS in the U.S. In large studies, it has been shown that the intravesical administration of US contrast agents in children is very safe. Comparative studies with VCUG have demonstrated the ability of ceVUS to detect more vesicoureteric refluxes. It would be useful to have ceVUS as a diagnostic option for pediatric vesicoureteric reflux along with VCUG and DRNC. Initially, one may focus using ceVUS for follow-up cases and gradually, with more experience, it is possible to expand the indications to include initial diagnoses.
Hands-on Obstetric Ultrasound Moderators: Julia Solomon, MD, Joan Mastrobattista, MD Participants will perform obstetric ultrasound examinations on second- and third-trimester models with supervision by and instruction from sonographer and physician experts.
Quantitative Ultrasound Moderators: Keith Wear, PhD, Sharat Lin, PhD, Jonathan Rubins, PhD The Best of Quantitative Ultrasound Michael Oelze, William D. O’Brien Department of Electrical and Computer Engineering, The University of Illinois at Urbana-Champaign, Urbana, Illinois, UNITED STATES Objective: The objective of these studies was to demonstrate that quantitative ultrasound (QUS) techniques could be used to improve diagnostic ultrasound imaging. Specifically, QUS techniques were applied to improving detection of breast and thyroid cancer, early detection of preterm birth, quantification of fatty liver and thermometry. Methods: QUS techniques were employed that utilized parameterization of the frequency-dependent backscatter coefficient, the attenuation coefficient and/or envelope statistics. The backscatter coefficient was parameterized through the effective scatterer diameter (ESD) and the effective acoustic concentration (EAC). Backscattered ultrasound data were acquired from tissue samples using clinical ultrasound scanners providing the RF signal and from laboratory systems utilizing single-element focused transducers. The data spanned frequency ranges from 2 to 50 MHz. Results: Combinations of the ESD, EAC and envelope statistics were successful in differentiating malignant from benign tumors in rodent models of breast cancer.
Four-Dimensional Fetal Cardiac Examination Moderator: Liat Gindes, MD
How to Evaluate Fetal Arrhythmias Mark Sklansky Pediatrics, UCLA, Los Angeles, California, UNITED STATES Fetal arrhythmias occur relatively commonly, but only rarely present real risk to fetal well-being. In such cases, fetal therapy or early delivery may be indicated. For this reason, proper evaluation of fetal arrhythmias should be performed for the fetus at risk. Sonographic evaluation should be performed after obtaining a detailed history, including important information regarding family history (i.e., WPW), maternal disease (i.e., S4
lupus), recent/ongoing infection, and exposure to arrhythmogenic agents (i.e., caffeine). As with fetal imaging in general, the evaluation of fetal arrhythmias should begin with a detailed, 2D (gray scale) evaluation of fetal cardiac anatomy and function, ideally including the use of color and pulsed Doppler. In many cases, the diagnosis of a fetal arrhythmia can be made with 2D and color flow imaging, alone. Commonly, however, pulsed Doppler, conventional m-mode, color m-mode and/or other techniques may improve the ability to make a precise and accurate diagnosis. The choice of which techniques to utilize depends as much on operator preference/experience as on fetal lie and arrhythmia. Once the diagnosis of a fetal arrhythmia has been made, the approach to management should consider the entirety of the fetus and pregnancy, acknowledging risks (maternal and fetal) and benefits of each therapeutic option (including observation or delivery). Care should be taken to obtain legitimate informed consent for any intervention. Happily, the vast majority of fetal arrhythmias carry an outstanding prognosis.
Moderators: Mary Beth McCarville, MD In this session, experts in pediatric contrast-enhanced ultrasound (CEUS) will discuss the current role of CEUS in the assessment of trauma, focal liver lesions, and voiding urosonography in children. The potential need for a pediatric CEUS registry and other regulatory issues will be discussed. Voding Urosonography – An Update Kassa Darge The Children’s Philadelphia Perelman School University of Pennsylvania
Hospital of of Medicine,
Contrast enhanced voiding urosonography (ceVUS) is the sonographic examination for vesicoureteric reflux (VUR). It is similar to fluoroscopic voiding cystourethrography (VCUG) and scintigraphic direct radionuclide cystography (DRNC). However, ceVUS achieves the diagnostic goal without utilization of radiation. The procedure of ceVUS encompasses bladder catheterization, administration of US contrast agent and US of the bladder and kidneys during filling and voiding. During the voiding phase a suprapubic and transperineal US of the urethra, a urethrosonography, is performed. Thus complete evaluation for vesicoureteric reflux and urethral pathology is possible. Over the past 15 years ceVUS has been increasingly employed for pediatric vesicoureteric reflux diagnosis in Europe. Different US contrast agents have been used off-label for ceVUS in children. Currently, the most widely used one is SonoVueÒ from Bracco. The ultrasound contrast agent OptisonÒ (General Electric) is now being utilized for ceVUS in the U.S. In large studies, it has been shown that the intravesical administration of US contrast agents in children is very safe. Comparative studies with VCUG have demonstrated the ability of ceVUS to detect more vesicoureteric refluxes. It would be useful to have ceVUS as a diagnostic option for pediatric vesicoureteric reflux along with VCUG and DRNC. Initially, one may focus using ceVUS for follow-up cases and gradually, with more experience, it is possible to expand the indications to include initial diagnoses.
Hands-on Obstetric Ultrasound Moderators: Julia Solomon, MD, Joan Mastrobattista, MD Participants will perform obstetric ultrasound examinations on second- and third-trimester models with supervision by and instruction from sonographer and physician experts.
Quantitative Ultrasound Moderators: Keith Wear, PhD, Sharat Lin, PhD, Jonathan Rubins, PhD The Best of Quantitative Ultrasound Michael Oelze, William D. O’Brien Department of Electrical and Computer Engineering, The University of Illinois at Urbana-Champaign, Urbana, Illinois, UNITED STATES Objective: The objective of these studies was to demonstrate that quantitative ultrasound (QUS) techniques could be used to improve diagnostic ultrasound imaging. Specifically, QUS techniques were applied to improving detection of breast and thyroid cancer, early detection of preterm birth, quantification of fatty liver and thermometry. Methods: QUS techniques were employed that utilized parameterization of the frequency-dependent backscatter coefficient, the attenuation coefficient and/or envelope statistics. The backscatter coefficient was parameterized through the effective scatterer diameter (ESD) and the effective acoustic concentration (EAC). Backscattered ultrasound data were acquired from tissue samples using clinical ultrasound scanners providing the RF signal and from laboratory systems utilizing single-element focused transducers. The data spanned frequency ranges from 2 to 50 MHz. Results: Combinations of the ESD, EAC and envelope statistics were successful in differentiating malignant from benign tumors in rodent models of breast cancer.
Four-Dimensional Fetal Cardiac Examination Moderator: Liat Gindes, MD
How to Evaluate Fetal Arrhythmias Mark Sklansky Pediatrics, UCLA, Los Angeles, California, UNITED STATES Fetal arrhythmias occur relatively commonly, but only rarely present real risk to fetal well-being. In such cases, fetal therapy or early delivery may be indicated. For this reason, proper evaluation of fetal arrhythmias should be performed for the fetus at risk. Sonographic evaluation should be performed after obtaining a detailed history, including important information regarding family history (i.e., WPW), maternal disease (i.e., S4