ARTIFACTS, PITFALLS, AND NORMAL VARIANTS

35 ARTIFACTS, PITFALLS, AND NORMAL VARIANTS




When I began my involvement with diagnostic ultrasonography three decades ago, this chapter would have been considered ludicrous. Virtually all of ultrasonography was considered to be either an artifact or a pitfall. Clinicians did not take this modality seriously, and few critical decisions were ever based on the results of the ultrasound examination alone. With time, improvements in both technology and our understanding of normal and abnormal findings made this a useful clinical diagnostic modality. It did not take long for important clinical decisions to be based solely on the results of the ultrasound examination, for example, surgery, early delivery of the fetus, or even termination of the pregnancy. This evolution, although welcomed by many, has placed a large responsibility on the sonographer. The phrase “primum non nocere,” or first do no harm, has never proven more true.


This chapter is not an attempt to explain the physical principles of ultrasound or artifact production. It is also unlikely that such a chapter could ever be all-inclusive. I have attempted to find examples of pitfalls, the diagnostic dilemmas that have the potential to lead us to the wrong diagnosis. I have tried to cover both basic potential pitfalls and some of the more esoteric normal variants. Undoubtedly, some readers will find examples here that are so basic as to seem almost insulting. I apologize in advance and will only respond that this chapter is meant to appeal to a wide audience of beginners and “well-seasoned” experts. I also do not attempt to give an overly detailed explanation for each example but try to offer what is theorized at the time.


If I am able to avoid one false-positive diagnosis and prevent unnecessary surgery, termination of a pregnancy, or even 20 weeks of an emotional roller coaster for the parents, I have fulfilled my goal.



PELVIS, GRAVID, AND NONGRAVID UTERUS







































































THE FIRST TRIMESTER













Mar 10, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on ARTIFACTS, PITFALLS, AND NORMAL VARIANTS
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