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Radiology
Echogenic Bowel
Built from Obstetric Imaging
What’s inside
7 sections · 64 slides
Overview
- What we will work through
The finding itself
Bowel that shines as brightly as bone
- Bowel that shines like bone
- Where the name comes from
- The iliac wing, the bone used as the yardstick
- How the diagnosis is defined
- What counts, and what does not
- Bright fetal bowel at eighteen weeks, shown at two gain settings
- How often it turns up
- 0.2–1.8%
- Isolated, or part of a bigger picture
Why the bowel looks bright
Six routes to the same picture
- Six things that can make bowel bright
- Swallowed blood: the simplest explanation
- From a bleed to a bright bowel
- Clues that point to a bleed
- A soft marker for chromosome problems
- What the numbers actually say
- Three copies of chromosome twenty-one
- Why a chromosome problem would do this
- Cell-free DNA changed the advice
- Cystic fibrosis: a broken salt gate
- The chloride channel that fails in cystic fibrosis
- From faulty channel to bright bowel
- How strong is the cystic fibrosis link
- Ask about the parents
- Babies who are not growing well
- When growth restriction is also present
- Blocked or malformed bowel
- Watch for the bowel widening
- Bright bowel at twenty weeks that later widened
- Gut conditions reported with this sign
- Infection caught in the womb
- Cells infected by cytomegalovirus under the microscope
- Other infections that have been reported
What it means for the pregnancy
Outcomes, resolution, and life after birth
- What a large pooled analysis found
- 3.3%
- What happens as the pregnancy goes on
- After the baby is born
Scanning it properly
Most of the risk of this diagnosis is the diagnosis itself
- The gain test, step by step
- The ultrasound transducer, the hand-held scan head
- Probe frequency changes the answer
- Two other things that inflate the rate
- When magnetic resonance imaging helps
- What the MRI pictures show
- What MRI still cannot do
- The differential in a single list
What to do about it
History, genetics, infection, and a repeat scan
- The path from finding to plan
- The history to take
- Bring in a genetic counsellor
- Which tests to offer, and which not
- Testing for cytomegalovirus
- How amniotic fluid is sampled
- Do not test for everything
- Keep watching the pregnancy
- If the bright area does not go away
- After delivery
Summary
What to carry away and what to say
- What the referring physician needs to know
- Key points, first half
- Key points, second half
- Suggested readings
- References
- References (continued)
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition