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Chapter 1

MEDRADSC 2M03 Chapter Notes - Chapter 1: Thalamus, Armoured Fighting Vehicle, Echogenicity


Medical Radiation Sciences
Course Code
Regy Mathew

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Patient preparation
- (HIS): hospital info system
- (EMR): shown when given the assigned number
- (RIS): radiology info system
- (MWL): modality worklist
o Info put into the u/s machine before RIS
Ultrasound report
- Age, LMP, gravididty, parity, pain, recent pelvic procedures, history
G3 P1 A1 T2
- 3 pregnancies
- 1 carried to full term
- 1 abortion
- 2 full term births
1st day of last LMP
- 2 weeks before conception
- EDD: estimated delivery date
- Put 2 pillows underneath her knees
Performing Antepartum OB ultrasound exam
- Confirm intrauterine pregnancy, no chance of eptopic
- Cause of vaginal bleeding or pelvic pain
- estimate gestational age
- see if its multiple pregnancies
- confirm viability, adjunct to chorionic villus sampling (CVS), embryo
transfer, and localization and removal of an intrauterine device
- assess for fetal anomalies such as anencephaly
- look for pelvic masses
- measure nuchal translucency (NT)
first trimester scans
- abdominally, vaginally or both
- if abdomen fails, use vaginal and the opposite
1. Evaluate the uterus and adnexa for the presence of a gestational sac. Find the sac if
there is one, and state the location.
- State whether you see an embryo

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- Record the CRL (crown-rump length)
o Helps determine gestational age
o This is the length of the human embryo from the head to the butt.
o More accurate than gestational sac diameter
- If no embryo, then see if the gestational sac has the yolk sac
- 2 ways to measure: diameter of gestational sac if there is an embryo , but if there isn’t
than is there a yolk sac
- If there is no sac or embryo, we look for intrauterine fluid collection, which is associated
with an ectopic pregnancy
o Measured in the late first trimester
o Also helps measure fetal age
2. Measure cardiac activity with M-MODE or CINE-LOOP
- Has to be real time observation
- If the CRL>5mm we should see cardiac motion, if not then we shouldn’t
3. Document the fetal number
- If you see more than one embryo, document more than one pregnancy
- Things that can make you thing theres another baby
o Incomplete amnion
o Inc in chorionic membrane by intrauterine hemmorage
4. Look at uterus, adnexal structures, cul-de-sac
- Look for any masses: state location and size
- Scan cul-de-sac to look for fluid
o IF YES, scan flanks and sub hepatic space for intra-abdominal fluid
- Look at serum hormonal levels and correlate them to see if it’s a normal pregnancy
5. Look at nuchal region in the presence of a live fetus
- Measure NT and look at risk for trisomy 13 or 18
2nd and 3rd trimester sonography
1. Document the fetal life
- Any abnormal heart rates
- More than one baby includes more information
2. Record AFV
- Amniotic fluid volume
3. Location of the placenta
- See where it is in relation to the os
- Umbilical cord going from fetus to mom
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