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Ultrasound

Obstetrics

Current projects in obstetric ultrasound include evaluation of intracranial hemorrhage, evaluation of fetal brain abnormalities and multiple projects regarding use of magnetic resonance imaging (MRI) in obstetrics.

Ultrasound is an ideal imaging modality to evaluate pregnant patients since it is noninvasive, requires no ionizing radiation and is relatively inexpensive. However, there are cases in which further imaging is needed in order to better evaluate an anomaly seen in the fetus. Magnetic resonance imaging (MRI) is another imaging modality that is noninvasive and without ionizing radiation. We use MRI commonly in a research protocol sponsored by the National Institutes of Health to assess the fetal central nervous system.

Screening for abnormalities for which prenatal diagnosis is limited, such as tuberous sclerosis and hemachromotosis also is possible with MRI.

Abdomen

Members of the Ultrasound Section are involved in several clinical and basic science research projects. The large Colorectal Surgery Division allows us to study accuracy of endorectal US in detecting and staging tumors (Radiographics 1997; 17: 609-626) and for imaging patients where cancer is incidentally detected in polyps removed during sigmoidoscopy (Radiology 1999; 211: 31-35). In addition, a large IBD service provides a host of opportunities for performing endoanal US for evaluating anal sphincter morphology and for characterizing perianal fistulae using hydrogen peroxide fistulography during ultrasound. Under Dr Kane's guidance, the section continues to be involved in an ongoing multicenter study of prostate cancer detection.

With a major interest in liver disease, the section is involved in ongoing studies of portosystemic shunt evaluation (Radiographics), intraoperative ultrasound of the pancreas (Radiographics 1997; 17: 1618), bile ducts (Surgical Technology International VIII 1999; 8:96-104) and liver, (Critical Reviews in Diagnostic Imaging, 1995;36(3):175-226) and in developing strategies for intraoperative imaging during adult right lobe liver transplantation (AJR 2000, In press). Clinical intraoperative US requirements support projects on IOUS of the bile ducts, pancreas and liver, and development of laparoscopic US techniques. Other areas of interest include US-guidance during cryoablation and Radiofrequency ablation.

At the basic science level, projects include correlation of sonographic peritumoral halos with intravital histopathology in colorectal metastases (Radiology 2000;215: 852-7), and through support of the RSNA (J Kruskal, RSNA Scholar 1999-2000) and Society of Gastrointestinal Radiologists (Philip H. Meyers and Roscoe E. Miller Awards 1999 and 2000), for ongoing evaluation of US as a tool for enhancing targeted and sustainable gene delivery into tumors.

Fetal Aneuploidy

The guidelines in these pages provide additional information about commonly misunderstood ultrasound findings of fetal aneuploidy and serve to standardize information provided by radiologists to obstetric providers.

Publications