Inflammatory Conditions- Fetal Development
description
Transcript of Inflammatory Conditions- Fetal Development
![Page 1: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/1.jpg)
Inflammatory Conditions- Fetal Development
![Page 2: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/2.jpg)
Inflammatory Processes
• Process:– Increased vascular permeability
• Water and cellular infiltrations• Results:
–Abscess, ulceration, cavitation• Penetration, perforation and fistula
formation–Scarring, strictures
![Page 3: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/3.jpg)
Inflammatory Processes
• Lungs and pleura• Gastrointestinal tract• Soft tissues of extremities• Brain
![Page 4: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/4.jpg)
Inflammatory Lung, Mediastinal and Pleural Diseases
• Bronchitis–Acute–Chronic
• Pneumonia– Infective–Chemical
![Page 5: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/5.jpg)
Inflammatory Lung, Mediastinal and Pleural Diseases
• Pulmonary abscess• Pleuritis• Empyema• Lymphadenopathy
![Page 6: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/6.jpg)
Pulmonary Air Space Pattern(Consolidation or Infiltration)
• Alveoli filled with pus, water, blood, cells, protein
• Appearance- fluffy, ill defined margins
• Single (segmental or lobar), multiple, or diffuse distribution
• Rapid development
![Page 7: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/7.jpg)
Pulmonary Air Space Pattern(Consolidation or Infiltration)
• Air bronchograms –fluid filled alveoli surround air filled bronchi
• Butterfly shadow–E.G. Pneumonia, alveolar
pulmonary edema
![Page 8: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/8.jpg)
LUL Lingular
Pneumonia
• Obliterated left cardiac border
![Page 9: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/9.jpg)
LULLingular
Pneumonia Lateral
• Consolidation anterior to the major fissure
• Compare to PA exam
![Page 10: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/10.jpg)
LULLingular Pneumonia
![Page 11: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/11.jpg)
LLL Pneumonia
• Air space disease left lower lobe
• Density behind heart
• Obliteration of left diaphragm at edge of heart
• Left heart border preserved
![Page 12: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/12.jpg)
LLL Pneumonia• Note
obliteration of the posterior portion of the left diaphragm (arrows)
• Right diaphragm clearly seen
![Page 13: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/13.jpg)
RLL Pneumonia
• Density at the right lateral diaphragm
• Obliteration of lateral diaphragm border
![Page 14: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/14.jpg)
RLL Pneumonia
• Density at the mid diaphragm
• Sharp margination at the major fissure (arrows)
![Page 15: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/15.jpg)
Lung Abscess• Thick walled
irregular cavity RUL
• Fluid level representing partial evacuation of necrotic material via airway
![Page 16: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/16.jpg)
Lung Abscess
• Thick walled irregular cavity RUL
• Fluid level representing partial evacuation of necrotic material via airway
![Page 17: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/17.jpg)
Pulmonary Interstitial Pattern• Fluid or cells in the pulmonary
interstitial space–e.g. Peribronchial tissue and
bronchial wall, perivascular space and vessels, lymphatic structure
• Alveoli aerated
![Page 18: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/18.jpg)
Pulmonary Interstitial Pattern• Appearance:
–Linear, lattice-like, or multiple small nodules
• Examples:–Cystic fibrosis, bronchiectasis,
asbestosis, silicosis, and other pneumoconiosis
![Page 19: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/19.jpg)
Cystic Fibrosis• Bronchial wall
thickening• Ring shadows and
parallel bronchiole walls of bronchiectasis
• Ill-defined linear lesions
• Obstructive airway with low diaphragms
![Page 20: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/20.jpg)
Interstitial Edema CHF
• Bilateral central interstitial linear lattice pattern
• Small nodular lesions
• Ill-defined enlarged hila
• Septal lines (Kerley’s)
• Multiple horizontal lines near costophrenic angles (Kerley B)
![Page 21: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/21.jpg)
Interstitial Edema CHF• Variation in
another patient
• Cardiomegaly• Pulmonary
vascular changes as on prior patient
![Page 22: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/22.jpg)
Classic Pulmonary Edema
• Batwing or butterfly appearance
• Smoke inhalation
![Page 23: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/23.jpg)
Pleural Inflammatory Lesion
• Pleural effusion (hydrothorax due to exudate, transudate, blood, etc.)
• Pleural thickening, adhesion, calcification resulting from prior inflammatory process
• Usually associated with concurrent lung disease
![Page 24: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/24.jpg)
Right Pleural Effusion• Fluid density
right base• Upward concave
border extends along the right lateral chest wall
• Some lower lung obscured
• Incidentally noted implanted infusion device (arrow)
![Page 25: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/25.jpg)
Pleural Effusion
• Blunting of both costophrenic angles (arrows)
• Loss of lower heart margins
![Page 26: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/26.jpg)
Pleural Effusion - Plaque• Calcified
plaque along both lateral chest walls (arrows)
• Result of Asbestos exposure
• Some plaque along diaphragm
![Page 27: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/27.jpg)
Pleural Effusion - Plaque• Calcified
plaque along both posterior chest walls (arrows)
• Result of asbestos exposure
![Page 28: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/28.jpg)
Esophageal Inflammatory Disease
• Esophagitis commonly due to infection–Bacteria–Virus–Fungus
• Gastroesophageal reflex
![Page 29: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/29.jpg)
Esophageal Inflammatory Disease
• Chemical substance corrosion• Radiologic manifestations of
different causes of esophagitis are similar
• No radiologic abnormalities when degree of inflammation is mild
![Page 30: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/30.jpg)
Normal Esophagus• Barium in
esophagus• Smooth indentation
anterior wall upper third from the aortic arch
• Focal ‘ring’ distal esophagus at gastric junction
![Page 31: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/31.jpg)
Esophageal Candidiasis
• Multiple oval filling defects along the esophageal mucousa
• Plaques of candida along the esophagus (filling defects in barium coating)
![Page 32: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/32.jpg)
Gastrointestinal Inflammatory Disease
• Mucosal changes– Swelling: local or diffuse enlargement of
mucosal folds– Defect: ulceration
• Penetration, perforation and abscess formation (ULCER CRATER)
– Scarring: stricture• Need to use contrast (barium) study to
illustrate the lumen and inner wall of GI tract
![Page 33: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/33.jpg)
Gastric and Duodenal Ulcers• Benign ulcer:
–Ulcer projects beyond lumen–Sharp margin, round barium dot
viewed en face–Edematous halo around ulcer in acute
stage–Mucosal folds radiate out like spokes
of wheel in sub-acute or chronic stage
![Page 34: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/34.jpg)
• Gas in fundus of stomach
• Opacification of stomach, duodenum and jejunum
• Peristalsis in the distal duodenal bulb
Normal Gastrointestinal Study
![Page 35: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/35.jpg)
Normal Barium Enema• Single
contrast exam• Notice the
normal haustrations
• Competent ileocecal valve
![Page 36: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/36.jpg)
NormalBarium Enema
• Double (air) contrast
• Supine image• Coating of
mucosa and distended with gas
• Appendix is filled with barium
![Page 37: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/37.jpg)
Development And Its
Anomolies
![Page 38: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/38.jpg)
Embryo Milestones Detected by Ultrasound
• Gestation sac• Yolk sac• Embryo• Placenta
4.5-5 weeks5 weeks5-6 weeks8 weeks
![Page 39: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/39.jpg)
Early Gestation• Longitudinal
scan• Anechoic
structure• Echogenic rim• Gestational sac• Cervix
Bladder
Sac
![Page 40: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/40.jpg)
Embryo• Endovaginal
scan, more detail, resolution
• Gestational sac, embryo (cursors), yolk sac
• Gestational age 8 weeks 4 days
![Page 41: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/41.jpg)
Yolk Sac• Yolk sac
indicated by two white arrows
• Amniotic membrane visible as faint curvilinear echoes in sac
25
![Page 42: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/42.jpg)
Embryonic Heart
25
![Page 43: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/43.jpg)
12 Week Fetus
• Longitudinal scan
• Fetal head in profile
• Placenta located anterior
![Page 44: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/44.jpg)
Fetal Head 30 Weeks• Normal head axial view level
of ventricles• Central echogenic line =
third ventricle line• Ventricles(hypechoic) and
choroid plexus(echogenic)• Gray echogenic
area=parenchyma• Outer echogenic
rim=calvarium
![Page 45: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/45.jpg)
• Four chamber heart view
• Heart chambers labeled
Normal Fetal Chest
RA
RV
LA
LV
![Page 46: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/46.jpg)
Fetal Chest and Abdomen
• Sagittal view• Rib shadows • Abdominal
contents
Ribs
Bowel
![Page 47: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/47.jpg)
Normal Fetal Abdomen
• Axial at level of kidneys
• Echogenic dots above represent spine(arrow)
• Kidneys (arrowhead)
![Page 48: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/48.jpg)
Normal Fetal Pelvis
• Section through level of bladder
• Oval hypoechoic area represents bladder (arrow)
• Femurs parallel linear echogenic (A)
• Sacrum under arrow
A
![Page 49: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/49.jpg)
Normal Fetal Spine
• Sagittal view C,T, L spine
• Parallel row of dots represent ossification centers of pedicles and bodies
• Note: images not true sagittal
![Page 50: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/50.jpg)
Normal Fetal Spine
• Axial view• Level of cervical,
thoracic and lumbar vertebrae
• Ossification centers triangular arrangement
• Body in center, pedicles lateral
• * At the center of each spinal canal
*
*
*
![Page 51: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/51.jpg)
Fetal Femur
![Page 52: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/52.jpg)
Fetal Cord Insertion
• Transverse abdomen
• Cord insertion midline
• White represents doppler evaluation of blood flow in cord
FetalAbdomen
![Page 53: Inflammatory Conditions- Fetal Development](https://reader035.fdocuments.in/reader035/viewer/2022062520/568165fa550346895dd92977/html5/thumbnails/53.jpg)
3 Vessel Cord
V A