Volume 8 Issue 3 - Australasian Society for Ultrasound in Medicine

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HS Wong, K Burns, L Strand and S Parkerthree perpendicular planes targeting the internal cervicalos with 2D imaging (including the use of colour Doppler)gives a reliable equivalent 3D imaging of the area and canbe very useful in the diagnosis and differential diagnosis ofvasa previa.References1 Naftolin F and Mishell DR Jr. Vasa previa. Report of 3 cases. ObstetGynecol 1965; 26 (4): 561–565.2 Pent D. Vasa previa. Am J Obstet Gynecol 1979; 134 (2): 151–155.3 Fung TY and Lau TK. Poor perinatal outcome associated with vasaprevia: is it preventable? A report of three cases and review of theliterature. Ultrasound Obstet Gynecol 1998; 12 (6): 430–433.4 Gianopoulos J, Carver T, Tomich PG, Karlman R, Gadwood K.Diagnosis of vasa previa with ultrasonography. Obstet Gynecol 1987;69 (3 Pt 2): 488–491.5 Nelson LH, Melone PJ, King M. Diagnosis of vasa previa with transvaginaland color flow Doppler ultrasound. Obstet Gynecol 1990; 76(3 Pt 2): 506–509.6 Lee W, Kirk JS, Comstock CH, Romero R. Vasa previa: prenataldetection by three-dimensional ultrasonography. Ultrasound ObstetGynecol 2000; 16 (4): 384–387.30 ASUM Ultrasound Bulletin 2005 August; 8 (3)
ASUM Ultrasound Bulletin 2005 August; 8 (3): 31–32DIAGNOSTIC ULTRASOUNDA pictorial essay of left ventricular failureJustin O’Leary BExSc, DMURoyal Prince Alfred Hospital, Camperdown, Sydney, New South Wales, AustraliaCorrespondence to Justin_Oleary@hotmail.comFigure 1 Figure 2Clinical historyA 74-year-old male presented for an outpatient cardiacassessment prior to surgical treatment of a left renal tumour.Reported symptoms included occasional episodes of centralchest tightness during rest as well as on exertion. There wasno past history of other cardiac disease. On examination,the pulse was 100 and regular with occasional extrasystoles,the systolic blood pressure was 120/95, the JVP was raisedat 8 cm with the cardiac impulse laterally displaced. Onauscultation there was an apical pan-systolic murmur anda third heart sound. The ECG showed sinus rhythm withleft axis deviation and diffuse T-wave abnormalities. Thechest x-ray showed cardiomegaly. An echocardiogram wasrequested to assess left ventricular systolic function.Materials and methodsThe echocardiogram was performed on a GE medical systemVivid 7. A multi-frequency (1.5 – 4.0 MHz) phasedarray transducer was used in real time for 2D (harmonicand non-harmonic), M-mode, colour flow, continuous andpulsed wave Doppler examination. A frequency of 1.7 MHzfrequency with harmonic imaging was selected for adequatepenetration and resolution. Depth settings, overall gain,TGC, colour and spectral Doppler settings and focal zoneswere set to allow optimal imaging of structures of interest.The mechanical index (MI) was 1.0 and the thermal index(TI) was 0.7–1.5. The total imaging time was 30 minutes.TechniqueParasternal long axis views of the left ventricle showedmild to moderately impaired systolic contraction with mildantero-septal wall hypokinesis and severe posterior hypokinesis.The mitral valve appeared mildly echodense withnormal leaflet excursion. The aortic valve appeared mildlyechodense with normal excursion and cusp separation.M-mode through the aortic valve demonstrated a normalsized aortic root and, superiorly, a normal ascending aortawith mild dilatation of the left atrium. M-mode across themitral valve showed an increase in the mitral valve E pointto septal separation (EPSS) indicating left ventricular dilatation.M-mode through the left ventricle showed a mildlyincreased left ventricular end-diastolic dimension andreduced systolic thickening of both the antero-septal andposterior walls. The calculated ejection fraction (afterTeicholtz and Simpson) was 37%. There was mild concentricleft ventricular hypertrophy.Colour Doppler revealed a very mild central jet of aorticregurgitation and mild mitral regurgitation.The right ventricular inflow view showed a normal tricuspidvalve with normal valve excursion. The right atriumappeared mildly dilated. Colour Doppler revealed a milddegree of tricuspid regurgitation. The continuous waveDoppler across the jet shows a pressure difference betweenthe right ventricle and right atrium of 39 mmHg with spectralbroadening indicating mild severity.The right ventricular outflow tract view with colourDoppler and continuous wave Doppler across the pulmonaryvalve showed normal outflow velocities.The parasternal short axis view showed the commissureof the non-coronary aortic cusp was mildly thickened. Theleft ventricle visualised at the level of the papillary musclesshowed a mild to moderate global impairment in systolicfunction.Apical views of the mitral valve and tricuspid valvesshowed normal excursion. The left ventricular lateral andseptal walls showed reduced contraction with impaired contractionof the lateral wall of the right ventricle, mild bi-atrialASUM Ultrasound Bulletin 2005 August; 8 (3)31
Page 1 and 2: ISSN 1441-6891Volume 8 Number 3 Aug
Page 3 and 4: PresidentDr David RogersImmediate P
Page 5 and 6: ientific Meeting of ASUMe r 2005 Ad
Page 7 and 8: ASM 2005 PROFFERED PAPERSFriday 30t
Page 9 and 10: THE EXECUTIVEPresident’s messageD
Page 11 and 12: THE EXECUTIVEAdelaide ASMLooking ah
Page 13 and 14: The DMU (Asia) will deliver high te
Page 15 and 16: THE EXECUTIVEMember ServicesSonogra
Page 17 and 18: ASUM Ultrasound Bulletin 2005 Augus
Page 19 and 20: D Fauchon, S Watson and R Benzieor
Page 21 and 22: ASUM Ultrasound Bulletin 2005 Augus
Page 23: Fetal upper abdominal masses; a pre
Page 26 and 27: RP Davies, T McClymont and D Boshel
Page 28 and 29: RP Davies, T McClymont and D Boshel
Page 30 and 31: CASE REPORTASUM Ultrasound Bulletin
Page 34 and 35: Justin O’learyFigure 3 Figure 4co
Page 36 and 37: POLICIES and STATEMENTSFetal struct
Page 38 and 39: SOCIAL SCREENINGDraft of a letter s
Page 40 and 41: SOCIAL SCREENINGSonographerMelbourn
Page 42 and 43: THE SOCIETYSUMCertified ISO 9001:20
Page 44 and 45: THE SOCIETYDiploma of Medical Ultra
Page 46 and 47: EDUCATIONExamination dates for 2005
Page 48 and 49: THE SOCIETYThe 2004 Beresford Butte
Page 50 and 51: OBITUARYJames Robert Syme MD, FRACP
Page 52 and 53: THE SOCIETYCorporate Members 2005Au
Page 54 and 55: CALENDARContact Byung Ihn Choi MDCo
Page 56: ASUM ULTRASOUND BULLETIN VOLUME 8 N

Volume 8 Issue 3 - Australasian Society for Ultrasound in Medicine

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