Textbook of Diagnostic Sonography

1622 Pages·2017·309.74 MB·English

EIGHTH EDITION VOLUME ONE AND VOLUME TWO
TEXTBOOK OF
D I AG NO S T I C
S O NOG R A P H Y
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EIGHTH EDITION VOLUME ONE AND VOLUME TWO
TEXTBOOK OF
D I A G N O S T I C
S O N O G R A P H Y
Sandra L. Hagen-Ansert, MS,
RDMS, RDCS, FASE, FSDMS
Cardiology Department
Manager, Echo Labs
Scripps Clinic & Hospitals—La Jolla, California
3251 Riverport Lane
St. Louis MO 63043
TEXTBOOK OF DIAGNOSTIC SONOGRAPHY, EIGHTH EDITION ISBN: 978-0-323-35375-5
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C O N T R I B U T O R S
Alicia Armour, MA, BS, RDCS Charlotte G. Henningsen, MS, RT(R), Carol Mitchell, PhD, RDMS, RDCS,
Cardiovascular Sonographer RDMS, RVT, FSDMS, FAIUM, RVT, RT(R), FASE, FSDMS
Duke University Health System ADU, RT(R) University of Wisconsin
Duke Cardiac Diagnostic Unit, Chair and Professor Atherosclerosis Imaging Research
Level III Sonography Department Program
Durham, North Carolina Adventist University of Health Assistant Professor
Sciences Section of Cardiovascular Medicine
Joan P. Baker Orlando, Florida Madison, Wisconsin
President, Sound Ergonomics
Kenmore, Washington Talisha Hunt, BSRT, RDMS, RDCS, Cindy A. Owen, RT, RDMS, RVT,
RVT FSDMS
Carolyn Coffin Clinical Sonographer Global Luminary and Research
CEO, Sound Ergonomics Mayo Clinic, Department of Manager
Kenmore, Washington Sonography Radiology and Vascular Ultrasound
Rochester, Minnesota GE Healthcare
Marveen Craig, RDMS
Milwaukee, Wisconsin
Tucson, Arizona Mariana Kozirovsky, MS, RDMS,
RDCS Susan Raatz Stephenson, MEd,
M. Robert DeJong, RDMS, RVT,
Assistant Professor BSRT-U, RDMS, RT(R)(C)
FAIUM, FSDMS
Long Island University International Foundation for
Radiology Technical Manager,
Brooklyn, New York Sonography Education and
Ultrasound
Research Scientist Research
The Johns Hopkins Hospital
NYU School of Medicine AIUMcommunities.org
Baltimore, Maryland
New York, New York Sandy, Utah
Terry J. DuBose, MS, RDMS, FSDMS,
Fredrick W. Kremkau, PhD, RACR, Deziree Rada, RDMS, RVT
FAIUM
FAIMBE, FAIUM, FASA Sonography Department
Associate Professor Emeritus
Professor of Radiologic Sciences Adventist University of Health Sciences
Diagnostic Medical Sonography
Director, Program for Medical Orlando, Florida
University of Arkansas for Medical
Ultrasound
Sciences Center for Applied Learning Mitzi Roberts, EdD, RDMS, RDCS,
Austin, Texas Wake Forest University School of RT(R)
Pamela M. Foy, MS, RDMS, FSDMS Medicine Director of Institutional Effectiveness
Maternal Fetal Medicine Winston-Salem, North Carolina Baptist College of Health Science
Memphis, Tennessee
Imaging Manager
Daniel I. Lebovic, MD
Clinical Associate Professor, Reproductive Endocrinologist/Fertility Jean Lea Spitz, MPH, RDMS
Department of OB/GYN Specialist Nuchal Translucency Quality Review
Columbus, Ohio Center for Reproductive Medicine Program
Candace Goldstein, BS, RDMS Minneapolis, Minnesota Maternal Fetal Medicine Foundation
Oklahoma City, Oklahoma
Sonographer Educator Scripps Clinics
Daniel A. Merton, BS, RDMS,
Scripps Clinic–Carmel Valley FSDMS, FAIUM Diana M. Strickland, BS, RDMS,
San Diego, California ECRI Institute RDCS
Joy Guthrie, PhD, RDMS, RDCS, Senior Project Officer Clinical Assistant Professor and
RVT, FSDMS Health Devices Group Co-Director
Advanced Practice Sonographer Plymouth Meeting, Pennsylvania Ultrasound Program
Department of Obstetrics and
Program Director Diagnostic Medical
Gynecology
Sonography
Brody School of Medicine
Community Regional Medical Center
East Carolina University
Fresno, California
Greenville, North Carolina
vii
viii CONTRIBUTORS
Shpetim Telegrafi, MD Kerry Weinberg, PhD, RDMS, RDCS, Janette Wybo, BAS, RDMS, RDCS, RVT
Assistant Professor RT(R), FSDMS Diagnostic Medical Sonography
Director, Diagnostic Ultrasound Director and Associate Professor Program Coordinator
NYU School of Medicine, Department Diagnostic Medical Sonography Providence Hospital/Madonna
of Urology Program University
New York City, New York Long Island University–Brooklyn Campus Southfield, Michigan
Brooklyn, New York
Barbara Trampe, RN, RDMS Kathryn E. Zale, MS, BA, RDMS,
Chief Sonographer Marquita Williams, BS, RDMS RVT
Meriter/University of Wisconsin Technical Site Manager Former Clinical Coordinator
Perinatal Ultrasound Ultrasound System Modality Manager Sonography/Vascular Technology
Madison, Wisconsin Florida Hospital Radiology Enterprise Radiologic Sciences and Therapy
Orlando, Florida Ohio State University–College of
Kevin R. Volz, PhD, RVT Medicine
Research Lab Manager Columbus, Ohio
Laboratory for Investigatory Imaging
Instructor/Vascular Technology
Clinical Coordinator
School of Health and Rehabilitation
Sciences
Division of Radiologic Sciences and
Therapy
Ohio State University–College of
Medicine
Columbus, Ohio
P R E F A C E
INTRODUCING THE EIGHTH EDITION Sonographic findings for particular pathologic condi-
tions are always preceded in the text by the following special
The eighth edition of Textbook of Diagnostic Sonography heading:
continues the tradition of excellence that began when the first Sonographic Findings This icon makes it very easy for
edition was published in 1978. Like other medical imaging students and practicing sonographers to locate this clinical
fields, diagnostic sonography has seen dramatic changes and information quickly.
innovations since its first clinical experimental days. Phe-
nomenal strides in transducer design, instrumentation, three-
Study and Review Opportunities
dimensional (3D) and four-dimensional (4D) imaging, image
processing, tissue harmonics, and contrast agents continue to Study and review are also essential to gaining a solid grasp
improve image resolution and the diagnostic clinical value of of the concepts and information presented in this textbook.
sonography. The eighth edition has kept abreast of advance- Learning objectives, chapter outlines, “Key Pearls” that sum-
ments in the field by inviting new contributors currently marize the chapter highlights, comprehensive glossaries of
working in different areas of medical sonography throughout key terms, full references for cited material, and a list of com-
the country. The critiques and suggestions from multiple re- mon medical abbreviations printed on the inside back cover
viewers have helped ensure that this edition includes the most all help students learn the material in an organized and thor-
complete and up-to-date information needed to meet the re- ough manner.
quirements of the modern student of sonography.
Scope and Organization of Topics
Distinctive Approach
The Textbook of Diagnostic Sonography is divided into eight
This textbook can serve as an in-depth resource both for stu- parts:
dents of sonography and for practitioners in any number of Part I introduces the reader to the foundations of sonogra-
clinical settings, including hospitals, clinics, and private prac- phy and patient care and includes the following:
tices. Care has been taken to cultivate readers’ understand- • Foundations of sonography, which includes the basic
ing of the patient’s total clinical picture even as they study so- principles of ultrasound physics and medical sonography
nographic examination protocol and technique. To this end, • Terminology frequently encountered by the sonographer
each chapter covers the following: • Patient care for the sonographer
• Key terminology • Ergonomics and musculoskeletal issues for practi-
• Normal anatomy (including cross-sectional anatomy) tioners
• Normal physiology • Anatomic and physiologic relationships within the ab-
• Laboratory data and values dominopelvic cavity
• Pathology • Comparative sectional anatomy of the abdominopelvic
• Sonographic evaluation of an organ cavity
• Sonographic findings • Imaging and Doppler artifacts
• Pitfalls in sonography Part II presents the abdomen in depth. The following topics
• Clinical findings are discussed:
• Differential considerations • Anatomic relationships and physiology
• “Key Pearls” • Abdominal scanning techniques and protocols
The full-color art program is of great value to the student • Abdominal applications of ultrasound contrast agents
of anatomy and pathology for sonography. Detailed line • Ultrasound-guided interventional techniques
drawings illustrate the anatomic information a sonographer • Emergent abdominal ultrasound procedures
must know to successfully perform specific sonographic • Sonographic techniques in the transplant patient
examinations. Multiple color photographs of gross pathol- • Separate chapters for the vascular system, liver, gall-
ogy help the reader visualize some of the pathology pre- bladder and biliary system, spleen, pancreas, gastroin-
sented, and color Doppler illustrations are included where testinal tract, urinary system, retroperitoneum, and
relevant. peritoneal cavity and abdominal wall
To make important information easy to find, key points Part III focuses on the superficial structures of the body,
are pulled out into numerous boxes; tables throughout the including the breast, thyroid and parathyroid glands,
chapters summarize the pathology under discussion and scrotum, and musculoskeletal system.
break the information down into Clinical Findings, Sono- Part IV is completely new and explores sonographic exami-
graphic Findings, and Differential Considerations. nation of the neonate and pediatric patient.
xi
xii PREFACE
Part V focuses on the thoracic cavity and includes the follow- Anatomic and Physiologic Relationships within the Ab-
ing topics: dominopelvic Cavity (Chapter 4) introduces the reader to
• Anatomic and physiologic relationships within the tho- body systems and anatomic relationships, which include
racic cavity membranes and ligaments and potential spaces in the body.
• Hemodynamics Comparative Sectional Anatomy of the Abdominopelvic
• Echocardiographic evaluation and techniques Cavity (Chapter 5) is an introduction to sectional anatomy
• Introduction to clinical echocardiography incorporating gross anatomy with comparative ultrasound
• Fetal echocardiography and computed tomography sectional images.
Part VI comprises four chapters on extracranial and intracra- Basic Ultrasound Imaging: Techniques, Terminology, and
nial cerebrovascular imaging and peripheral arterial and Tips (Chapter 6) describes scanning techniques, terminology,
venous sonographic evaluation. abdominal ultrasound protocol, and abdominal Doppler
Part VII is devoted to gynecology and includes the following technique.
topics: Imaging and Doppler Artifacts (Chapter 7) is an outstand-
• Normal anatomy and physiology of the female pelvis ing review of all the artifacts commonly encountered by so-
• Sonographic and Doppler evaluation of the female nographers. There are numerous examples of the various ar-
pelvis tifacts and detailed explanations of how these artifacts are
• Separate chapters on the pathologic conditions of the produced and how to avoid them.
uterus, ovaries, and adnexa Sonographic Techniques in the Transplant Patient (Chapter
• Updated chapter on the role of sonography in evaluat- 20) is completely new to this edition and focuses on criteria
ing female infertility required for organ transplantation, including liver transplant,
Part VIII takes a thorough look at obstetric sonography. The renal transplant, and pancreatic transplant.
following topics are discussed: Thyroid and Parathyroid Glands (Chapter 22) is com-
• The role of sonography in obstetrics pletely updated with beautiful illustrations.
• Clinical ethics for obstetric sonography The entire pediatrics section (Chapters 25 to 29) has been
• Normal first-trimester findings and first-trimester fully updated with exquisite new illustrations for each chapter.
complications Understanding Hemodynamics (Chapter 31) introduces
• Sonography of the second and third trimesters the student to blood flow dynamics, intracardiac pressures
• Obstetric measurements and gestational age and fetal and volumes, Doppler basics, and quantification of intracar-
growth assessment diac pressures by ultrasound.
• Sonography in the high-risk pregnancy Introduction to Clinical Echocardiography: Left-Sided Val-
• Prenatal diagnosis of congenital anomalies vular Heart Disease (Chapter 33) and Introduction to Clinical
• Chapters are devoted to the placenta, umbilical cord, Echocardiography: Pericardial Disease, Cardiomyopathies, and
amniotic fluid and fetal membranes, fetal face and Tumors (Chapter 34) have been added to this edition to pro-
neck, neural axis, thorax, anterior abdominal wall, ab- vide understanding of significant cardiac findings that may be
domen, urogenital system, and skeleton encountered by the general sonographer or clinician.
The entire cerebrovascular section (Chapters 37 to 40) has
been updated with new images and current techniques for
New to This Edition
the sonographer.
Eight new contributors joined the eighth edition to update
and expand existing content, bringing with them a fresh per-
Student Resources
spective and an impressive knowledge base. They also helped
contribute the more than 1000 images new to this edition, Workbook. Available for separate purchase, Workbook for
including color Doppler, 3D and 4D, and contrast-enhanced Textbook of Diagnostic Sonography has also been completely
images. More than 30 new line drawings complement the new updated and expanded. This resource gives the learner ample
chapters found in the eighth edition. opportunity to practice and apply the information presented
Essentials of Patient Care for the Sonographer (Chapter 2) in the textbook.
covers all aspects of patient care the sonographer may en- • Each workbook chapter covers all the material pre-
counter, including taking and understanding vital signs, han- sented in the textbook.
dling patients on strict bed rest, patients with tubes and oxy- • Each chapter includes exercises on image identifica-
gen, patient transfer techniques, infection control, isolation tion, anatomy identification, key term definitions, and
techniques, emergency medical situations, assisting patients sonographic technique.
with special needs, and patient rights. • A set of 30 case studies using images from the textbook
Ergonomics and Musculoskeletal Issues in Sonography invites students to test their skills at identifying key
(Chapter 3) outlines the importance of proper technique and anatomy and pathology and describing and interpret-
positioning throughout the sonographic examination as a ing sonographic findings.
way to avoid long-term disability problems that may be ac- • Students can also test their knowledge with the hun-
quired with repetitive scanning. dreds of multiple-choice questions found in the four
PREFACE xiii
examinations covering different content areas: General Evolve Online Course Management. Evolve is an inter-
Sonography, Pediatric, Cardiovascular Anatomy, and active learning environment designed to work in coordina-
Obstetrics and Gynecology. tion with Textbook of Diagnostic Sonography. Instructors may
Evolve. On the Evolve site, students will find review ques- use Evolve to include an Internet-based course component
tions for each chapter. that reinforces and expands on the concepts delivered in
class. Evolve may be used to do all of the following:
• Publish the class syllabus, outlines, and lecture notes
Instructor Resources
• Set up virtual office hours and email communication
Resources for instructors are also provided on the Evolve site • Share important dates and information on the online
to assist in the preparation of classroom lectures and activities. class calendar
• PowerPoint lectures for each chapter that include il- • Encourage student participation with chat rooms and
lustrations discussion boards
• Test bank of 1500 multiple-choice questions in Exam- • Post examinations and manage grade books
view and Word For more information, visit http://www.evolve.elsevier.com/
• Electronic image collection that includes all the images HagenAnsert/diagnostic/ or contact an Elsevier sales repre-
from the textbook both in PowerPoint and in jpeg format sentative.