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CHAPTER27Peripheral VesselsMark E. Lockhart, Heidi R. Umphrey, Therese M. Weber, and Michelle L. RobbinSUMMARY OF KEY POINTS• Key aspects of vascular Doppler imaging includeknowledge of anatomy and waveform morphology,scanning technique, and attention to detail.• Spectral Doppler velocity criteria can characterize stenosisdetected by gray-scale and color Doppler.• Doppler evaluation of peripheral artery disease can providediagnostic information and enable surgical planning andevaluation of bypass grafts.• Extremity aneurysm and pseudoaneurysm have typicalDoppler indings similar to other areas of the arterialsystem.• Evaluation of the upper and lower extremityvenous system is primarily performed withsonography.• Differentiation of acute from residual or chronic deepvenous thrombosis (DVT) with imaging and clinicalparameters is often dificult.• Controversial venous issues include clinical criteria fortreatment of DVT, when to recommend a follow-upexamination, calf vein evaluation, and two-point or focusedexamination approach.• Preoperative sonographic mapping of upper extremity andthigh vessels assists surgical planning for placement ofhemodialysis arteriovenous istula (AVF) and grafts.• Postoperative evaluation of hemodialysis AVF and graftswith ultrasound aids the assessment of AVF maturation, aswell as evaluation for access stenosis, steal, thrombus,and focal complications.CHAPTER OUTLINEPERIPHERAL ARTERIESSonographic Examination TechniqueStenosis EvaluationLower Extremity ArteriesNormal AnatomyUltrasound Examination and ImagingProtocolPeripheral Arterial OcclusionPeripheral Arterial StenosisAneurysmPseudoaneurysmArteriovenous FistulaLower Extremity Vein BypassGraftsUpper Extremity ArteriesNormal AnatomyUltrasound Examination and ImagingProtocolArterial Occlusion, Aneurysm, andPseudoaneurysmArterial StenosisSubclavian StenosisThoracic Outlet SyndromeRadial Artery Evaluation for CoronaryBypass GraftPERIPHERAL VEINSSonographic Examination TechniqueLower Extremity VeinsNormal AnatomyUltrasound Examination and ImagingProtocolAcute Deep Venous ThrombosisResidual (Chronic) Deep VenousThrombosisPotential PitfallsComplete Venous Doppler VersusMore Limited ExaminationsRecommendations for Deep VenousThrombosis Follow-UpVenous InsuficiencyVenous MappingUpper Extremity VeinsNormal AnatomyUltrasound Examination and ImagingProtocolUpper Extremity Acute Deep VenousThrombosisDifferentiation of Acute FromResidual or Chronic VenousThrombosisPotential PitfallsHEMODIALYSISSonographic Examination TechniqueVascular Mapping Before HemodialysisAccessUpper ExtremityUltrasound Examination and ImagingProtocolArteriovenous Fistula and GraftArteriovenous FistulaGraftPalpable Focal Masses NearArteriovenous Fistula and GraftArteriovenous Fistula MaturationEvaluationArteriovenous Fistula and GraftStenosisArterial StealArm and Leg Swelling WithArteriovenous Fistula or GraftArteriovenous Fistula and GraftOcclusionCONCLUSION964
CHAPTER 27 Peripheral Vessels 965Prior chapters have described details of physics of Doppleranalysis and use of ultrasound in the assessment of thevasculature supplying the head and neck. In this chapter wedescribe assessment of the peripheral arteries and veins, as wellas arteriovenous istula (AVF) and grats. In general, these areasare readily evaluated by Doppler ultrasound. Because they areusually located at depths of 6 cm or less, the extremity vesselsare more consistently imaged than those in the abdomen orthorax. Availability of suicient imaging windows allows thetransducer to be placed over the vascular area of interest withoverlying tissue containing bone or gas. Transducers with frequenciesgreater than 5 MHz can typically be used.Gray-scale sonography is useful for evaluating the presenceof atherosclerotic plaque or conirming extravascular masses.Color low Doppler imaging allows for a rapid survey of the areaof interest, and then spectral Doppler can be used to characterizeblood low patterns.Standardized protocols, such as those provided by the AmericanCollege of Radiology (ACR), American Institute of Ultrasoundin Medicine, and Society of Radiologists in Ultrasound shouldbe followed. 1,2 It is recommended that examinations be performedin an accredited laboratory with participation in one of thevascular accreditation programs, such as the ACR or the IntersocietalCommission for the Accreditation of Vascular Laboratories,in order to achieve a national standard of excellence andto improve the chance of success of peripheral arterial and venousultrasound examinations. 3 In the setting of a dedicated staf andwith physician support, ultrasound can be used to diagnose manyperipheral vascular abnormalities deinitively and avoid the needfor ionizing radiation or intravenous contrasted cross-sectionalstudies.PERIPHERAL ARTERIESA variety of symptoms and signs can be evaluated by arterialultrasound. Sonographic examination is relatively rapid and hasbeneits over other modalities, such as real-time technique, lackof ionizing radiation, and relatively low expense. In the last twodecades, the number of indications for peripheral artery ultrasoundhas expanded. he most recent ACR practice parameteron the topic lists indications for the examination, which includeclaudication and/or rest pain in the lower extremities to evaluatefor arterial stenosis or occlusion. 2 Patients with pain, discoloration,or ulcer formation in the extremities (most commonly lower)may have tissue ischemia or necrosis from arterial stenosis orocclusion. Additional symptoms of numbness or cold extremitymay be noted. However, symptomatology may vary dependingon the rapidity of onset and whether collaterals have developedto decrease the efects of stenosis on the tissues. In some patients,vascular abnormalities may be subclinical and found incidentallyon imaging for other indications. Once an abnormality hasbeen identiied, ultrasound can monitor progression of disease,determine success or failure ater intervention, and identifyacceptable vessels for bypass grat creation.Other extremity abnormalities can be evaluated sonographically.Focal masses can be assessed to exclude vascular causessuch as aneurysm or istula with venous enlargement. Whenchronic positional upper extremity symptoms are present,ultrasound can evaluate for thoracic outlet syndrome. Moreperipherally, Doppler can document patency of the palmar archin surgical planning for bypass grat harvesting, and it can assessthe radial artery before and ater vascular access.In the acute setting, traumatic injuries can be evaluated todetermine adjacent arterial patency. Pseudoaneurysms anddissections are visible by ultrasound in these patients. Speciiclevels of embolic disease can also be depicted.Sonographic Examination TechniqueGray-scale evaluation of the peripheral arteries is important todetermine the amount of atherosclerotic disease or thrombuspresent. he highest frequency transducer that allows goodpenetration and visualization should be applied, typically a 5- to12-MHz linear array transducer, with a higher frequency transducerused in areas where the arteries are more supericial.Occasionally, a 3- to 5-MHz sector or curved array probemay be necessary in large patients or those with large amountsof edema.Occasionally, atherosclerotic plaque or thrombus is hypoechoic,and color Doppler is extremely useful to evaluate residual lumen,with the gain adjusted so color does not overlap into adjacenttissues. he spectral Doppler gate is adjusted within the lumenof the artery to allow adequate signal. he scale and gain shouldbe optimized to show strong low signals that use most of thescale to display the waveform. Normally, a medium or high wallilter is used in arterial evaluation. If there is slow low, a lowwall ilter may be used to improve detection. In general, fordetection of small channels of slow low in areas of near-occlusion,power Doppler may be more sensitive than color Doppler. 4However, the advances in color Doppler may have reduced thisdiference in recent years.he components of the sonographic evaluation difer basedon the indication. For example, imaging for suspected arterialstenosis or occlusion is very diferent from evaluation of a focalmass or aneurysm. he technical components of the examinationhave been recently described in the ACR practice parameters. 2Stenosis EvaluationColor and spectral Doppler imaging are key to stenosis evaluation,using a combination of waveform morphology and velocitycharacteristics. On gray-scale imaging, a focal stenosis or occlusionmay be visible, but this should be conirmed by Doppler. Collateralsshould also prompt additional attention with Doppler.Any areas of visible narrowing or turbulent color Doppler signalshould be further characterized with spectral Doppler. A changein spectral waveform morphology from one arterial segment tothe next should also be further evaluated with color and spectralDoppler to locate a point of transition (Fig. 27.1). Spectral Dopplershould be performed in the longitudinal plane and should beangle corrected 60% or less from the center beam. If a jet at ordownstream from a stenosis is seen, angle correction parallel tothe orientation of the jet should be performed to more accuratelymeasure peak systolic velocity (PSV). Using this technique,waveform morphology and peak velocity should be evaluatedat any suspected area of stenosis, as well as the feeding vessel
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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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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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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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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 1317 and 1318:
ABCDFIG. 33.13 Hypertelorism With E
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ABCDFIG. 33.16 Dacryocystocele. (A)
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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
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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
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CHAPTER 34 The Fetal Brain 1211Huma
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CHAPTER 34 The Fetal Brain 1213121.
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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
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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
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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
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CHAPTER 36 The Fetal Chest 1245seco
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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
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CHAPTER 36 The Fetal Chest 1253ABCF
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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
Page 1439 and 1440:
CHAPTER 36 The Fetal Chest 1267107.
Page 1441 and 1442:
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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CHAPTER 41 Fetal Hydrops 1413ABFIG.
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ABCDFIG. 41.2 Ascites. (A) Fluid ou
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CHAPTER 41 Fetal Hydrops 1417A B CD
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CHAPTER 41 Fetal Hydrops 1423later
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CHAPTER 41 Fetal Hydrops 1427CHABCH
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CHAPTER 41 Fetal Hydrops 1429Monoch
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CHAPTER 41 Fetal Hydrops 1431feedin
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CHAPTER 41 Fetal Hydrops 1433TABLE
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CHAPTER 41 Fetal Hydrops 1435sampli
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CHAPTER 41 Fetal Hydrops 1437Predel
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CHAPTER 41 Fetal Hydrops 143973. Ma
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CHAPTER 41 Fetal Hydrops 1441169. I
Page 1615 and 1616:
CHAPTER42Fetal Measurements: Normal
Page 1617 and 1618:
CHAPTER 42 Fetal Measurements 1445F
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CHAPTER 42 Fetal Measurements 1447T
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CHAPTER 42 Fetal Measurements 1451p
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CHAPTER 42 Fetal Measurements 1453d
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CHAPTER 42 Fetal Measurements 1455A
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CHAPTER 42 Fetal Measurements 1459A
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CHAPTER 42 Fetal Measurements 14618
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CHAPTER 42 Fetal Measurements 14631
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CHAPTER43Sonographic Evaluation oft
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CHAPTER 43 Sonographic Evaluation o
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CHAPTER44Cervical Ultrasound and Pr
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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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Page 1897 and 1898:
Page 1899 and 1900:
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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 1991 and 1992:
Page 1993 and 1994:
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Page 1997 and 1998:
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Page 2003 and 2004:
Page 2005 and 2006:
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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Page 2091 and 2092:
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CHAPTER 55 The Pediatric Hip and Ot
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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 2173 and 2174:
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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Page 2249:
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