Textbook of Diagnostic Sonography

1398 Pages·2011·397.15 MB·English

by  Sandra L. Hagen-Ansert

SEVENTH EDITION VOLUME ONE
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
Supervisor, Echo Lab
Scripps Clinic—Torrey Pines, California
with 3,463 illustrations
3251 Riverport Lane
St. Louis, Missouri 63043
TEXTBOOK OF DIAGNOSTIC SONOGRAPHY ISBN: 978-0-323-07301-1
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To my daughters,
Becca, Aly, and Kati,
who are changing the world one day at a time
C O N T R I B U T O R S
Joan Baker, MSR., RDMS, RDCS Mira L. Katz, PhD, MPH Mitzi Roberts, BS, RDMS, RVT
President, Sound Ergonomics Associate Professor Chair, Assistant Professor
Kenmore, Washington Division of Health Behavior and Diagnostic Medical Sonography
Health Promotion Program
Carolyn Coffin, MPH, RDMS, School of Public Health Baptist College of Health Science
RDCS, RVT The Ohio State University Memphis, Tennessee
CEO, Sound Ergonomics Columbus, Ohio
Kenmore, Washington Jean Lea Spitz, MPH, RDMS
Fredrick Kremkau, PhD Maternal Fetal Medicine
Marveen Craig, RDMS Professor & Director Foundation
Diagnostic Ultrasound Consultant Center for Medical Ultrasound Nuchal Translucency Quality
Tucson, Arizona Wake Forest University School of Review Program
Medicine Oklahoma City, Oklahoma
M. Robert De Jong, RDMS, RDCS, Winston-Salem, North Carolina
RVT Susan Raatz Stephenson, MEd,
Radiology Technical Manager, Salvatore LaRusso, MEd, RDMS, BSRT-U, RDMS, RT(R)(C)
Ultrasound RT (R) International Foundation for
The Russell H. Morgan Department Technical Director Sonography Education &
of Radiology Penn State Hershey/ Hershey Research
and Radiological Science Medical Center AIUM communities.org
The Johns Hopkins Hospital Department of Radiology Sandy, Utah
Baltimore, Maryland Hershey, Pennsylvania
Diana M. Strickland, BS,
Terry J. DuBose, MS, RDMS Daniel A. Merton, BS, RDMS RDMS, RDCS
Associate Professor and Director Technical Coordinator of Research Clinical Assistant Professor and
Diagnostic Medical Sonography The Jefferson Ultrasound Research Co-Director
Program and Educational Institute Ultrasound Program
University of Arkansas for Medical Thomas Jefferson University Department of Obstetrics and
Sciences Philadelphia, Pennsylvania Gynecology
Little Rock, Arkansas Brody School of Medicine
Carol Mitchell, PhD, RDMS, East Carolina University
Pamela Foy, M.S., RDMS RDCS, RVT, RT(R) Greenville, North Carolina
Clinical Instructor, Department OB/ Quality Assurance Coordinator,
GYN UW AIRP Shpetim Telegrafi, M.D.
The Ohio State University Medical Program Director, University of Assistant Professor
Center Wisconsin School of Diagnostic Director, Diagnostic Ultrasound
Columbus, Ohio Medical Ultrasound NYU School of Medicine,
University of Wisconsin Hospitals Department of Urology
Candace Goldstein, BS, RDMS & Clinics New York City, New York
Sonographer Educator Madison, Wisconsin
Scripps Clinic Carmel Valley Barbara Trampe, RN, RDMS
San Diego, California Cindy A. Owen, RT, RDMS, RVT Chief Sonographer
Global Luminary and Research Meriter/University of Wisconsin
Charlotte G. Henningsen, Manager Perinatal Ultrasound
MS, RT (R), RDMS, RVT Radiology & Vascular Ultrasound Madison, Wisconsin
Chair and Professor GE Healthcare
Diagnostic Medical Sonography Memphis, Tennessee
Department
Florida Hospital College of Health
Sciences
Orlando, Florida
vii
viii CONTRIBUTORS
Barbara J. Vander Werff, RDMS, Ann Willis, MS, RDMS, RVT Dennis Wisher, BS, RDMS, RVT
RDCS, RVT Assistant Professor, Diagnostic Director of Education and Product
Chief Sonographer Medical Sonography Program Management
University of Wisconsin-Madison Baptist College of Health Sciences Medison America, Inc.
Hospitals and Clinics Memphis, Tennessee Cypress, California
Madison, Wisconsin
Kerry Weinberg, MS, RDMS,
RDCS
Director
Diagnostic Medical Sonography
Program
New York University
New York, New York
R E V I E W E R S
Jan Blend, MS, RT(R), RDMS, Marianna C. Desmond, BS, RT(R), Kasey L. Moore, ARRT, RDMS,
ARDMS RDMS RT(R) (M) (RDMS)
Program Coordinator, Diagnostic Clinical Coordinator, Diagnostic Sonography Instructor
Medical Sonography Medical Sonography Program Danville Area Community College
El Centro College Triton College Danville, Illinois
Dallas, Texas River Grove, Illinois
Susan M. Perry, BS, ARDMS
Katherine K. Borok, BS, RDMS, Jann Dolk, MA, RT(R), RDMS Program Director, Diagnostic
RDCS Adjunct Faculty, Diagnostic Medical Sonography
Clinical Coordinator Medical Sonography Program Owens Community College
American Institute of Ultrasound in Palm Beach State College Toledo, Ohio
Medicine Palm Beach Gardens, Florida
Laurel, Maryland Kellee Ann Stacks, BS, RTR,
Ken Galbraith, MS, RT(R), RDMS, RDMS, RVT
Joie Burns, MS, RT(R)(S), RDMS, RVT Program Director, Medical
RVT State University of New York Sonography
Associate Professor, Program Syracuse, New York Cape Fear Community College
Director, Diagnostic Medical Wilmington, North Carolina
Sonography Karen M. Having, MS Ed, RT,
Boise State University RDMS
Boise, Idaho Associate Professor, School of
Allied Health
Saretta C. Craft, MS, RDCS, RVT Southern Illinois
Program Director, Diagnostic University-Carbondale
Sonography Carbondale, Illinois
St. Catharine College
St. Catharine, Kentucky Bridgette Lunsford, BS, RDMS,
RVT
Laura L. Currie, BS, RT(R), Adjunct Faculty, George
RDMS, RVT Washington University
Clinical Coordinator Washington, D.C.
Cape Fear Community College
Wilmington, North Carolina
ix
P R E F A C E
discussion and break the information down into
INTRODUCING THE SEVENTH EDITION
Clinical Findings, Sonographic Findings, and Differential
The seventh edition of Textbook of Diagnostic Sonogra- Considerations.
phy continues the tradition of excellence that began Sonographic findings for particular pathologic condi-
when the first edition published in 1978. Like other tions are always preceded in the text by the following
medical imaging fields, diagnostic sonography has seen special heading:
dramatic changes and innovations since its first experi- Sonographic Findings. This icon makes it very easy
mental days. Phenomenal strides in transducer design, for students and practicing sonographers to locate this
instrumentation, color-flow Doppler, tissue harmonics, clinical information quickly.
contrast agents, and 3D imaging continue to improve Study and review are also essential to gaining a solid
image resolution and the diagnostic value of sonography. grasp of the concepts and information presented in this
The seventh edition has kept abreast of advancements in textbook. Learning objectives, chapter outlines, compre-
the field by having each chapter reviewed by numerous hensive glossaries of key terms, full references for cited
sonographers currently working in different areas of material, and a list of common medical abbreviations
medical sonography throughout the country. Their cri- printed on the back inside cover all help students learn
tiques and suggestions have helped ensure that this the material in an organized and thorough manner.
edition includes the most complete and up-to-date infor-
mation needed to meet the requirements of the modern
Scope and Organization of Topics
student of sonography.
The Textbook of Diagnostic Sonography is divided into
eight parts:
Distinctive Approach
This textbook can serve as an in-depth resource both for Part I introduces the reader to the foundations of sono-
students of sonography and for practitioners in any graphy and patient care and includes the following:
number of clinical settings, including hospitals, clinics, • Basic principles of ultrasound physics and medical
and private practices. Care has been taken to cultivate sonography
readers’ understanding of the patient’s total clinical • Terminology frequently encountered by the
picture even as they study sonographic examination pro- sonographer
tocol and technique. To this end, each chapter covers the • Overview of physical findings, physiology, and
following: laboratory data
• Patient care for the sonographer
• Normal anatomy (including cross-sectional anatomy)
• Ergonomics and musculoskeletal issues for
• Normal physiology
practitioners
• Laboratory data and values
• Basics of other imaging modalities
• Pathology
• Image artifacts
• Sonographic evaluation of an organ
Part II presents the abdomen in depth. The following
• Sonographic findings
topics are discussed:
• Pitfalls in sonography
• Anatomic relationships and physiology
• Clinical findings
• Abdominal scanning techniques and protocols
• Differential considerations
• Abdominal applications of ultrasound contrast
The full-color art program is of great value to the agents
student of anatomy and pathology for sonography. • Ultrasound-guided interventional techniques
Detailed line drawings illustrate the anatomic informa- • Emergent abdominal ultrasound procedures
tion a sonographer must know to successfully perform • Separate chapters for the vascular system, the
specific sonographic examinations. Color photographs liver, gallbladder and biliary system, pancreas,
of gross pathology help the reader visualize some of the gastrointestinal tract, urinary system, spleen,
pathology presented, and color Doppler illustrations are retroperitoneum, and peritoneal cavity and abdom-
included where relevant. inal wall
To make important information easy to find, key Part III focuses on the superficial structures in the body
points are pulled out into numerous boxes; tables including the breast, thyroid and parathyroid glands,
throughout the chapters summarize the pathology under scrotum, and musculoskeletal system.
xi
xii PREFACE
Part IV explores sonographic examination of the neonate technique and positioning throughout the sonographic
and pediatric patient. examination as a way to avoid long-term disability prob-
Part V focuses on the thoracic cavity and includes: lems that may be acquired with repetitive scanning.
• Anatomic and physiologic relationships within the Understanding Other Imaging Modalities (Chapter 5)
thoracic cavity is a comparative overview of the multiple imaging
• Echocardiographic evaluation and techniques modalities frequently encountered by the sonographer:
• Fetal echocardiography computerized tomography, magnetic resonance, positron
Part VI comprises four chapters on extracranial and emission tomography (PET), nuclear medicine, and
intracranial cerebrovascular imaging and peripheral radiography.
arterial and venous sonographic evaluation. Artifacts in Scanning (Chapter 6) is an outstanding
Part VII is devoted to gynecology and includes the fol- review of all the artifacts commonly encountered by
lowing topics: sonographers. There are numerous examples of the
• Normal anatomy and physiology of the female various artifacts and detailed explanations of how these
pelvis artifacts are produced and how to avoid them.
• Sonographic and Doppler evaluation of the female 3D and 4D Evaluation of Fetal Anomalies (Chapter
pelvis 54) has a three-fold focus: (1) to introduce the sonogra-
• Separate chapters on the pathologic conditions of pher to the technical concepts of 3D ultrasound; (2)
the uterus, ovaries, and adnexa to acquaint the sonographer with the 3D tools
• Updated chapter on the role of sonography in eval- currently available; and (3) to provide clinical examples
uating female infertility of the integration of 3D ultrasound into conventional
Part VIII takes a thorough look at obstetric sonography. sonographic examinations. Although a chapter with
The following topics are discussed: this title appeared in the last edition, this chapter
• The role of sonography in obstetrics has been entirely rewritten and includes all new
• Clinical ethics for obstetric sonography illustrations.
• Normal first trimester and first-trimester
complications
Student Resources
• Sonography of the second and third trimesters
• Obstetric measurements and gestational age Workbook. Available for separate purchase, Workbook
• Fetal growth assessment for Textbook of Diagnostic Sonography has also been
• Prenatal diagnosis of congenital anomalies, with a completely updated and expanded. This resource gives
separate chapter on 3D and 4D evaluation of fetal the learner ample opportunity to practice and apply the
anomalies information presented in the textbook.
• Chapters devoted to the placenta, umbilical cord,
• Each workbook chapter covers all the material pre-
and amniotic fluid, as well as to the fetal face and
sented in the textbook.
neck, neural axis, thorax, anterior abdominal wall,
• Each chapter includes exercises on image identifica-
abdomen, urogenital system, and skeleton
tion, anatomy identification, key term definitions, and
sonographic technique.
New to This Edition • A set of 30 case studies using images from the text-
book invites students to test their skills at identifying
Ten new contributors joined the seventh edition to
key anatomy and pathology and describing and inter-
update and expand existing content, bringing with them
preting sonographic findings.
a fresh perspective and an impressive knowledge base.
• Students can also test their knowledge with the hun-
They also helped contribute the more than 1000 images
dreds of multiple choice questions found in the four
new to this edition, including color Doppler, 3D, and
exams covering different content areas: General
contrast-enhanced images. More than 30 new line draw-
Sonography, Pediatric, Cardiovascular Anatomy, and
ings complement the new chapters found in the seventh
Obstetrics and Gynecology.
edition.
Essentials of Patient Care for the Sonographer Evolve. On the Evolve site, students will find a printable
(Chapter 3) covers all aspects of patient care the sono- list of the key terms and definitions for each chapter; a
grapher may encounter, including taking and under- printable selected bibliography for each chapter, and
standing vital signs, handling patients on strict bed rest, Weblinks.
patients with tubes and oxygen, patient transfer tech-
niques, infection control, isolation techniques, emer-
Instructor Resources
gency medical situations, assisting patients with special
needs, and patient rights. Resources for instructors are also provided on the Evolve
Ergonomics and Musculoskeletal Issues in Sonogra- site to assist in the preparation of classroom lectures and
phy (Chapter 4) outlines the importance of proper activities.
PREFACE xiii
• PowerPoint lectures for each chapter that include • Publish the class syllabus, outlines, and lecture
illustrations notes
• Test bank of 1500 multiple-choice questions in Exam- • Set up virtual office hours and email communication
view and Word • Share important dates and information on the online
• Electronic image collection that includes all the images class calendar
from the textbook both in PowerPoint and in jpeg • Encourage student participation with chat rooms and
format discussion boards
• Post exams and manage grade books
Evolve Online Course Management. Evolve is an
interactive learning environment designed to work in For more information, visit http://www.evolve.elsevier.
coordination with Textbook of Diagnostic Sonography. com/HagenAnsert/diagnostic/ or contact an Elsevier
Instructors may use Evolve to include an Internet-based sales representative.
course component that reinforces and expands upon the
concepts delivered in class. Evolve may be used to: