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1458 PART IV Obstetric and Fetal Sonographymost cases, the BPP does not require a full 30 minutes ofsonographic evaluation, because, given the short sleep cycles ofthe fetus, it typically meets criteria in less than that time, sometimesas short as 5 minutes. 145he BPP as a test of fetal well-being has several limitations.First, the test is less reliable in the severely premature fetus becauseof lack of brain maturity and should not be administered before24 weeks’ gestation. 145 Second, the biophysical state of the fetusis afected by administration of corticosteroids, which may causedepression of fetal breathing and movement for a few days atertreatment. 151-155 his latter limitation must be kept in mind whenusing the BPP to guide management decisions shortly ater steroidtreatment. 145Fetal DopplerDoppler parameters of a number of vessels, including the umbilicalartery, umbilical vein, ductus venosus, middle cerebral artery,aortic isthmus, and uterine artery in the mother, have beenstudied to determine if Doppler parameters can be used topredict outcome and direct management. 140,156-160 Among vesselsstudied, umbilical artery Doppler has been shown to be themost useful for monitoring fetuses at risk for compromise,particularly those with suspected FGR. 11,140,148,156,160,161 Whenumbilical artery Doppler is incorporated into surveillance offetuses with suspected growth restriction, overall outcome isimproved, with fewer unnecessary interventions, inductions oflabor, cesarean deliveries, and perinatal deaths. 10,148,160-162 Althoughumbilical artery Doppler has been shown to improve outcomein fetuses with suspected growth restriction and in motherswith preeclampsia or hypertension, routine screening withumbilical artery Doppler in low-risk pregnancies is not recommended,because it has not resulted in improved outcome inthis patient population. 140,161Although some advocate adding middle cerebral arteryand/or ductus venosus Doppler to the evaluation of fetuseswith suspected growth restriction and abnormal umbilicalartery Doppler, 161,163-165 studies have not yet shown improvedoutcomes when these additional Doppler studies areperformed. 10,11,140,148,160Umbilical Artery DopplerUmbilical artery Doppler is used to assess fetal well-being ater24 weeks’ gestation for those fetuses with suspected growthrestriction or in mothers with preeclampsia or hypertension.140,148,156,160,161 To obtain a waveform, the Doppler gate is placedon a free loop of umbilical cord, away from the placental andfetal cord insertions and in the absence of fetal breathing movements.he ratio of peak systolic to end-diastolic velocity iscalculated (S/D ratio). Flow in the umbilical artery is normallylow resistance, with an S/D ratio of less than 3.5 up to 28 weeks’gestation and less than 3.0 thereater 166 (Fig. 42.12A). Withsigniicant placental dysfunction, resistance in the placentaincreases and low in the umbilical artery demonstrates diminisheddiastolic low, with an S/D ratio above the normal range (Fig.42.12B). In such cases, the risk of fetal compromise and perinatalmortality is increased. he risk of fetal compromise is increasedfurther when end-diastolic low in the umbilical artery is absent(Fig. 42.12C), and is highest when end-diastolic low is reversed(Fig. 42.12D). In particular, the risk of perinatal mortality within1 week of diagnosing reversed end-diastolic low in the umbilicalartery of a growth-restricted fetus is so high, close to 50%, thatdelivery is generally recommended, regardless of the gestationalage. 10,11,140,156,167-170Ductus Venosus Dopplerhe ductus venosus is the short vessel connecting the umbilicalvein near its junction with the let portal vein directly to theinferior vena cava. his allows shunting of umbilical venousblood directly to the heart, bypassing the liver. Normal low inthe ductus venosus is antegrade, toward the heart, throughoutthe cardiac cycle (Fig. 42.13A). Studies have shown that absentor reversed low (Fig. 42.13B) in the ductus venosus at any timeduring the cardiac cycle is a sign of cardiovascular instabilityand is associated with increased morbidity and mortality ratesin growth-restricted fetuses. 10,11,140,148,150,160 However, these samestudies demonstrate poor sensitivities and speciicities, and,therefore, the value of ductus venosus Doppler for directingthe management of growth-restricted fetuses has not beenestablished. 11,140,148,160Middle Cerebral Artery DopplerDoppler of the middle cerebral artery (MCA) provides informationabout low resistance in the fetal brain. For optimal interrogationof the MCA, the Doppler gate should be placed on the middlecerebral artery in the proximal third of the vessel, close to itsorigin from the circle of Willis. If peak systolic velocity is beingmeasured, the Doppler angle must be zero or angle correctionmust be used. Normally, low in the MCA is high resistance,with low diastolic low (Fig. 42.14A). In the compromised fetus,vessels in the brain vasodilate, a response called “brain sparing,”leading to decreased resistance to blood low and increaseddiastolic low in the MCA. his “brain-sparing” efect can bemeasured by calculating the resistive index (RI) of the MCAwaveform. he RI is considered abnormal when it is less thanthe ith percentile for gestational age 148,159,160 (Fig. 42.14B). Anabnormal RI in the MCA is associated with perinatal mortalityand morbidity, including acidosis at birth, low 5-minute Apgars,and neonatal intracranial hemorrhage. 148,159 However, the publishedstudies are inconsistent, and an abnormal MCA Doppleris a poor predictor of adverse outcome in preterm infants. hereis no convincing evidence that the use of MCA Doppler forguiding management of growth-restricted fetuses improvesoutcome. 10,148,160,171Some have advocated using the MCA Doppler in conjunctionwith umbilical artery Doppler to improve the identiication offetuses at risk for poor outcome. In particular, some have recommendedcomparing the RI or pulsatility index (PI) in the MCAto the corresponding RI or PI in the umbilical artery in a ratiocalled the “cerebroplacental ratio” (Fig. 42.15):Cerebroplacental ratioMiddle cerebral artery pulsatility index=Umbilical artery pulsatility index
CHAPTER 42 Fetal Measurements 1459ABCDFIG. 42.12 Umbilical Artery Doppler. (A) Color and spectral Doppler of umbilical artery demonstrating normal low with systolic to diastolicratio (S/D) normal at 2.13. (B) Sonogram of term fetus showing Doppler gate on umbilical artery and spectral waveform with elevated S/D of 4.15due to diminished diastolic low. (C) Sonogram showing Doppler gate on umbilical artery and spectral waveform below demonstrating absentend-diastolic low (arrows). (D) Color and spectral Doppler demonstrating reversed end-diastolic low (arrows).ABFIG. 42.13 Ductus Venosus Doppler. (A) Color and spectral Doppler of the ductus venosus demonstrating normal low, toward the heartthroughout the cardiac cycle. (B) Color and spectral Doppler of the ductus venosus demonstrating reversed low (arrows) during part of the cardiaccycle, an abnormal inding.
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viiiContributorsOlga R. Brook, MDAs
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xContributorsChristy K. Holland, Ph
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xiiContributorsRupa Radhakrishnan,
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xxiiContentsVOLUME IIPART IV Obstet
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xxivVideo ContentsVideo 12.8 Angiog
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xxviVideo ContentsVideo 26.20 High-
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xxviiiVideo Contents42 Fetal Measur
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2 PART I Physicsphysics. he amplitu
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4 PART I Physics× ms×FIG. 1.4 Ult
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6 PART I Physicsθ 1 = 20°Tissue A
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8 PART I Physicssignature. Broad-ba
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10 PART I PhysicsFIG. 1.13 B-Mode I
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12 PART I PhysicsIn these transduce
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14 PART I PhysicsFIG. 1.17 Tissue H
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16 PART I PhysicsKey Points of Ultr
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18 PART I PhysicsA - Normal liverv
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20 PART I PhysicsFIG. 1.27 Reverber
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22 PART I Physics-0 dBUncorrected-0
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24 PART I Physicsθ = 0°cos θ = 1
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26 PART I PhysicsABFIG. 1.38 Color
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28 PART I PhysicsChanges in Doppler
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30 PART I PhysicsABFIG. 1.44 Wall F
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32 PART I PhysicsABCDFIG. 1.46 Alia
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CHAPTER2Biologic Effects and Safety
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36 PART I PhysicsPressurePulse repe
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38 PART I PhysicsUltrasound imaging
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40 PART I Physicsacoustic power and
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42 PART I PhysicsFIG. 2.6 Acoustic
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44 PART I PhysicsThe AIUM Statement
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46 PART I Physics1. Current ultraso
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48 PART I PhysicsEPIDEMIOLOGYWith a
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50 PART I Physicscontrols whether t
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52 PART I Physics70. Hwang JH, Tu J
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54 PART I PhysicsA B 5 μmFIG. 3.1
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56 PART I Physicsstudies with Levov
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58 PART I Physicsabdominal organs.
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60 PART I PhysicsHarmonic B-Mode Im
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62 PART I PhysicsFIG. 3.9 Contrast-
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64 PART I Physicsdramatic manifesta
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66 PART I Physics5 µmFIG. 3.15 Fra
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68 PART I Physicsplatelet lysis), n
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70 PART I PhysicsEnhancement1 2 3 4
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72 PART I Physics46. Hamilton MF, B
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PART TWO: Abdominal and Pelvic Sono
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76 PART II Abdominal and Pelvic Son
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100 PART II Abdominal and Pelvic So
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ABFIG. 5.20 Microabscesses in Two P
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ABFIG. 6.32 Distal Cholangiocarcino
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CHAPTER7The PancreasThomas Winter a
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CHAPTER8The Gastrointestinal TractS
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ABFIG. 8.16 Lymphadenopathy in Two
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A B CD E FG H IFIG. 8.23 Inlammator
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FIG. 8.56 Gastrointestinal Stromal
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CHAPTER9The Kidney and Urinary Trac
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Remnant ofpronephrosMesonephrosBMes
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CHAPTER11The Adrenal GlandsChristin
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CHAPTER12The RetroperitoneumRaymond
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CHAPTER13Dynamic Ultrasound of Hern
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CHAPTER14The PeritoneumAnthony E. H
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CHAPTER15The UterusDouglas Brown an
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CHAPTER16The AdnexaRochelle Filker
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692 PART III Small Parts, Carotid A
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CHAPTER20The Parathyroid GlandsBonn
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*** *FIG. 21.8 Terminal Ductolobula
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CHAPTER22The ScrotumDaniel Sommers
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CHAPTER23Overview of Musculoskeleta
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CHAPTER25Musculoskeletal Interventi
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ABCDFIG. 25.15 Biceps Tendon Sheath
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CHAPTER27Peripheral VesselsMark E.
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ABFIG. 27.29 Chronic Deep Venous Th
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1000 PART III Small Parts, Carotid
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e2APPENDIXUltrasound Artifacts: A V
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FIG. A.18 Comet-Tail Artifact. On c
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e12APPENDIXUltrasound Artifacts: A
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I-2 IndexAcetabulumdescription of,
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I-4 IndexAnemiafetal, hydrops from,
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I-6 IndexAttenuationcoeicient, 36of
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I-8 IndexBlood low. See also Cerebr
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I-10 IndexBreast(s) (Continued)thic
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I-12 IndexCat-scratch disease, pedi
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I-14 IndexChorion laeve, 1465-1466C
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I-16 IndexContrast agents (Continue
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I-18 IndexCyst(s) (Continued) Cyst(
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I-20 IndexDoppler ultrasound (Conti
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I-22 IndexEndocardial cushion(s), 1
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I-24 IndexFibroma(s) (Continued)par
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I-26 IndexGerminal epithelium, 565G
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I-28 IndexHematoma(s) (Continued)pe
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I-30 IndexHoloprosencephaly (HPE) (
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I-32 IndexImplants, breast (Continu
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I-34 IndexJaundice (Continued)bile
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I-36 IndexLipomyelocele, closed spi
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I-38 IndexMammary ductsnormal sonog
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I-40 IndexMolar pregnancy. See Hyda
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I-42 IndexNonrhizomelic chondrodysp
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I-44 IndexPancreas (Continued)percu
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I-46 IndexPeritoneum (Continued)tum
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I-48 IndexPosterior fossa (Continue
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I-50 IndexPyloric musclehypertrophy
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I-52 IndexSample volume size, Doppl
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I-54 IndexSpectral broadening, in D
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I-56 IndexSuperoanteromedial ridge,
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I-58 Indexhrombosis (Continued)of s
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I-60 IndexTrisomy 18 (Edwards syndr
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I-62 IndexUrinary tract, pediatric
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I-64 IndexWalker-Warburg syndromeco
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DIAGNOSTICULTRASOUND
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DIAGNOSTICULTRASOUND5TH EDITIONCARO
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ABOUT THE EDITORSCarol M. Rumack, M
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ContributorsviiCONTRIBUTORSJacques
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ContributorsixPeter M. Doubilet, MD
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ContributorsxiAna P. Lourenco, MDAs
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ContributorsxiiiWendy hurston, MDAs
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In memory of my parents, Drs. Ruth
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PrefacexviiPREFACEhe ith edition of
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AcknowledgmentsxixACKNOWLEDGMENTSWe
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ContentsxxiCONTENTSVOLUME IPART I P
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Video ContentsxxiiiVIDEO CONTENTS4
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Video Contentsxxv19 The Thyroid Gla
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Video Contentsxxvii33 The Fetal Fac
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Video Contentsxxix52 The Pediatric
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DIAGNOSTICULTRASOUND
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PART FOUR: Obstetric and Fetal Sono
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CHAPTER 28 Overview of Obstetric Im
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ABCDFIG. 28.9 Second-Trimester Biom
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CHAPTER 29 Bioeffects and Safety of
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CHAPTER 30 The First Trimester 1049
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CHAPTER 31 Chromosomal Abnormalitie
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ABCDFIG. 31.12 Sonographic Findings
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CHAPTER32Multifetal PregnancyMary C
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CHAPTER 32 Multifetal Pregnancy 111
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ABFIG. 32.5 Sonographic Findings Se
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CHAPTER33The Fetal Face and NeckAna
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CHAPTER 33 The Fetal Face and Neck
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Page 1313 and 1314:
Page 1315 and 1316:
Page 1317 and 1318:
ABCDFIG. 33.13 Hypertelorism With E
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ABCDFIG. 33.16 Dacryocystocele. (A)
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Page 1325 and 1326:
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ABCDEFFIG. 33.24 Unilateral Complet
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CHAPTER 34 The Fetal Brain 1167impo
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CHAPTER 34 The Fetal Brain 1169cmAB
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CingulatePOCalcarineAB21 wkCD25 wkI
Page 1345 and 1346:
CHAPTER 34 The Fetal Brain 1173FIG.
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CHAPTER 34 The Fetal Brain 1175LTAR
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CHAPTER 34 The Fetal Brain 1177CC12
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CHAPTER 34 The Fetal Brain 1179SPEC
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CHAPTER 34 The Fetal Brain 1181ABCD
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CHAPTER 34 The Fetal Brain 1183asym
Page 1357 and 1358:
CHAPTER 34 The Fetal Brain 1185FIG.
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CHAPTER 34 The Fetal Brain 1187Cere
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CHAPTER 34 The Fetal Brain 1189loba
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CHAPTER 34 The Fetal Brain 1191ABCF
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CHAPTER 34 The Fetal Brain 1193ABCF
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CHAPTER 34 The Fetal Brain 1195spor
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ABCCCDEFFIG. 34.24 Type 2 Lissencep
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CHAPTER 34 The Fetal Brain 1199ABFI
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CHAPTER 34 The Fetal Brain 120120 w
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CHAPTER 34 The Fetal Brain 1203Ultr
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CHAPTER 34 The Fetal Brain 1205ABCD
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VSSABHHPHCDEFFIG. 34.35 Intracrania
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CHAPTER 34 The Fetal Brain 1209VABC
Page 1383 and 1384:
CHAPTER 34 The Fetal Brain 1211Huma
Page 1385 and 1386:
CHAPTER 34 The Fetal Brain 1213121.
Page 1387 and 1388:
CHAPTER 34 The Fetal Brain 1215221.
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CHAPTER 35 The Fetal Spine 1217ABCF
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CHAPTER 35 The Fetal Spine 1219L1S3
Page 1393 and 1394:
CHAPTER 35 The Fetal Spine 1221FTFT
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CHAPTER 35 The Fetal Spine 1223FIG.
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CHAPTER 35 The Fetal Spine 1225TABL
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CHAPTER 35 The Fetal Spine 1227Feta
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CHAPTER 35 The Fetal Spine 1229MMAB
Page 1403 and 1404:
ABCDEFFIG. 35.15 Skin-Covered Myelo
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CHAPTER 35 The Fetal Spine 1233diic
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CHAPTER 35 The Fetal Spine 1235CCSC
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CHAPTER 35 The Fetal Spine 1237chon
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CHAPTER 35 The Fetal Spine 1239BSCT
Page 1413 and 1414:
CHAPTER 35 The Fetal Spine 124162.
Page 1415 and 1416:
CHAPTER36The Fetal ChestDorothy Bul
Page 1417 and 1418:
CHAPTER 36 The Fetal Chest 1245seco
Page 1419 and 1420:
CHAPTER 36 The Fetal Chest 1247TABL
Page 1421 and 1422:
CHAPTER 36 The Fetal Chest 1249Left
Page 1423 and 1424:
CHAPTER 36 The Fetal Chest 12511ABC
Page 1425 and 1426:
CHAPTER 36 The Fetal Chest 1253ABCF
Page 1427 and 1428:
CHAPTER 36 The Fetal Chest 1255cent
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CHAPTER 36 The Fetal Chest 1257Left
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CHAPTER 36 The Fetal Chest 1259ABCD
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CHAPTER 36 The Fetal Chest 1261RTLT
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CHAPTER 36 The Fetal Chest 1263ARig
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CHAPTER 36 The Fetal Chest 12659. B
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CHAPTER 36 The Fetal Chest 1267107.
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CHAPTER 36 The Fetal Chest 1269204.
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CHAPTER 37 The Fetal Heart 1271TABL
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CHAPTER 37 The Fetal Heart 1273TABL
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CHAPTER 37 The Fetal Heart 1275Plac
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CHAPTER 37 The Fetal Heart 1277ADop
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CHAPTER 37 The Fetal Heart 1279LVRV
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CHAPTER 37 The Fetal Heart 1281RARV
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CHAPTER 37 The Fetal Heart 1283RARV
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CHAPTER 37 The Fetal Heart 1285Norm
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CHAPTER 37 The Fetal Heart 1287RVLV
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CHAPTER 37 The Fetal Heart 1289RVTA
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CHAPTER 37 The Fetal Heart 1291LVRA
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CHAPTER 37 The Fetal Heart 1293Aspl
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CHAPTER 37 The Fetal Heart 1295PLVL
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CHAPTER 37 The Fetal Heart 1297HR-L
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CHAPTER 37 The Fetal Heart 129951.
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CHAPTER 38 The Fetal Gastrointestin
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UrogenitalsinusMesonephrosMesonephr
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CHAPTER 39 The Fetal Urogenital Tra
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CHAPTER 40 The Fetal Musculoskeleta
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Page 1579 and 1580: CHAPTER 40 The Fetal Musculoskeleta
Page 1585 and 1586: CHAPTER 41 Fetal Hydrops 1413ABFIG.
Page 1587 and 1588: ABCDFIG. 41.2 Ascites. (A) Fluid ou
Page 1589 and 1590: CHAPTER 41 Fetal Hydrops 1417A B CD
Page 1595 and 1596: CHAPTER 41 Fetal Hydrops 1423later
Page 1599 and 1600: CHAPTER 41 Fetal Hydrops 1427CHABCH
Page 1601 and 1602: CHAPTER 41 Fetal Hydrops 1429Monoch
Page 1603 and 1604: CHAPTER 41 Fetal Hydrops 1431feedin
Page 1605 and 1606: CHAPTER 41 Fetal Hydrops 1433TABLE
Page 1607 and 1608: CHAPTER 41 Fetal Hydrops 1435sampli
Page 1609 and 1610: CHAPTER 41 Fetal Hydrops 1437Predel
Page 1611 and 1612: CHAPTER 41 Fetal Hydrops 143973. Ma
Page 1613 and 1614: CHAPTER 41 Fetal Hydrops 1441169. I
Page 1615 and 1616: CHAPTER42Fetal Measurements: Normal
Page 1617 and 1618: CHAPTER 42 Fetal Measurements 1445F
Page 1619 and 1620: CHAPTER 42 Fetal Measurements 1447T
Page 1621 and 1622: CHAPTER 42 Fetal Measurements 1449T
Page 1623 and 1624: CHAPTER 42 Fetal Measurements 1451p
Page 1625 and 1626: CHAPTER 42 Fetal Measurements 1453d
Page 1627 and 1628: CHAPTER 42 Fetal Measurements 1455A
Page 1629: CHAPTER 42 Fetal Measurements 1457T
Page 1633 and 1634: CHAPTER 42 Fetal Measurements 14618
Page 1635 and 1636: CHAPTER 42 Fetal Measurements 14631
Page 1637 and 1638: CHAPTER43Sonographic Evaluation oft
Page 1639 and 1640: CHAPTER 43 Sonographic Evaluation o
Page 1667 and 1668: CHAPTER44Cervical Ultrasound and Pr
Page 1669 and 1670: CHAPTER 44 Cervical Ultrasound and
Page 1681 and 1682:
CHAPTER 44 Cervical Ultrasound and
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PART FIVE: Pediatric SonographyCHAP
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CHAPTER 45 Neonatal and Infant Brai
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CHAPTER46Duplex Sonography of the N
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CHAPTER 46 Duplex Sonography of the
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CHAPTER47Doppler Sonography of the
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CHAPTER 47 Doppler Sonography of th
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CHAPTER 48 The Pediatric Head and N
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CHAPTER 49 The Pediatric Spinal Can
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Page 1865 and 1866:
RA B CDEFGFIG. 49.27 Neuroblastoma
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CHAPTER50The Pediatric ChestChetan
Page 1875 and 1876:
CHAPTER 50 The Pediatric Chest 1703
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CHAPTER 51 The Pediatric Liver and
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Page 1939 and 1940:
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Page 1943 and 1944:
ABCFIG. 51.39 Hepatosplenomegaly. W
Page 1945 and 1946:
Page 1947 and 1948:
CHAPTER52The Pediatric Urinary Trac
Page 1949 and 1950:
CHAPTER 52 The Pediatric Urinary Tr
Page 1951 and 1952:
TABLE 52.4 Mean Total Renal Volumes
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Page 2003 and 2004:
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CHAPTER53The Pediatric Gastrointest
Page 2007 and 2008:
CHAPTER 53 The Pediatric Gastrointe
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CHAPTER 54 Pediatric Pelvic Sonogra
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CHAPTER 55 The Pediatric Hip and Ot
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Page 2097 and 2098:
Page 2099 and 2100:
Page 2101 and 2102:
Page 2103 and 2104:
Page 2105 and 2106:
Page 2107 and 2108:
Page 2109 and 2110:
ABCDFIG. 55.13 Normal and Dislocate
Page 2111 and 2112:
Page 2113 and 2114:
Page 2115 and 2116:
CHAPTER 56 Pediatric Interventional
Page 2117 and 2118:
Page 2119 and 2120:
Page 2121 and 2122:
Page 2123 and 2124:
Page 2125 and 2126:
Page 2127 and 2128:
Page 2129 and 2130:
Page 2131 and 2132:
ABCFIG. 56.15 Access for Drainage o
Page 2133 and 2134:
Page 2135 and 2136:
Page 2137 and 2138:
Page 2139 and 2140:
Page 2141 and 2142:
APPENDIXUltrasound Artifacts: A Vir
Page 2143 and 2144:
APPENDIX Ultrasound Artifacts: A Vi
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Page 2175 and 2176:
Page 2177 and 2178:
Page 2179 and 2180:
IndexAAA anastomoses. See Arterial/
Page 2181 and 2182:
Index I-3Adnexa (Continued)transvag
Page 2183 and 2184:
Index I-5Arrays, transducer, 11-12A
Page 2185 and 2186:
Index I-7Bioefects (Continued) Biop
Page 2187 and 2188:
Index I-9Brain, neonatal/infant (Co
Page 2189 and 2190:
Index I-11Carcinoma(s) (Continued)
Page 2191 and 2192:
Index I-13Cervix (Continued)for sym
Page 2193 and 2194:
Index I-15Color Doppler ultrasound
Page 2195 and 2196:
Index I-17Cystic artery, 194promine
Page 2197 and 2198:
Index I-19Diabetes mellituschronic
Page 2199 and 2200:
Index I-21Echinococcal disease (Con
Page 2201 and 2202:
Index I-23Exudate ascites, 506-507E
Page 2203 and 2204:
Index I-25Gallbladder (Continued)ad
Page 2205 and 2206:
Index I-27Gyriabnormalities of, in
Page 2207 and 2208:
Index I-29Hernia(s). See also Diaph
Page 2209 and 2210:
Index I-31Hyperechoic tissue, in br
Page 2211 and 2212:
Index I-33Internal jugular vein (IJ
Page 2213 and 2214:
Index I-35Kidneys, pediatric (Conti
Page 2215 and 2216:
Index I-37Liver transplantation (Co
Page 2217 and 2218:
Index I-39Mesentery, small bowel, 5
Page 2219 and 2220:
Index I-41Nasal bone, fetal (Contin
Page 2221 and 2222:
Index I-43Orbits, fetal (Continued)
Page 2223 and 2224:
Index I-45Patau syndrome. See Triso
Page 2225 and 2226:
Index I-47Pleural efusionsfetal, 12
Page 2227 and 2228:
Index I-49Prostate (Continued)thera
Page 2229 and 2230:
Index I-51Renal transplantation (Co
Page 2231 and 2232:
Index I-53Shunt(s) (Continued) Skel
Page 2233 and 2234:
Index I-55Splenic vein (Continued)t
Page 2235 and 2236:
Index I-57Testis(es) (Continued)cys
Page 2237 and 2238:
Index I-59Transcranial Doppler (TCD
Page 2239 and 2240:
Index I-61Umbilical cord, 1481-1487
Page 2241 and 2242:
Index I-63Vein of Galen (Continued)
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