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Radiology

Trisomy 21

Built from Obstetric Imaging

The first 25 slides of Trisomy 21
The first 25 slides, exactly as they appear. The full deck has 89 content slides.

What’s inside

6 sections · 89 slides

  1. 01

    Overview

    • What this deck covers

    1 slide

  2. 02

    What trisomy 21 is

    One extra chromosome, and everything that follows from it

    • Chromosomes come in pairs — usually
    • An extra copy of chromosome 21
    • Who worked it out, and when
    • 1 in 800
    • Two things move the risk
    • Reading the age-and-gestation risk table
    • Chance of trisomy 21 by mother's age and weeks of pregnancy
    • Prevalence of Trisomy 21 by Maternal Age and Gestational Age
    • Prevalence of Trisomy 21 by Maternal Age and Gestational Age (continued)
    • Where the extra chromosome comes from
    • The three routes explained
    • Why an extra chromosome changes so much

    12 slides

  3. 03

    What the fetus looks like

    Major malformations first, then the small clues

    • How often the scan sees something
    • Major defect or soft marker?
    • The heart is the commonest problem
    • Heart defects: the population figures
    • Duodenal atresia: the blocked gut
    • Two fluid pockets side by side in the upper abdomen
    • What a likelihood ratio actually means
    • The rest of the findings
    • The soft markers at a glance
    • Ultrasound features grouped by type
    • Ultrasound Features of Trisomy 21

    11 slides

  4. 04

    How we screen for it

    Blood tests, scans, and where the definite answer comes from

    • Screening tells you odds, not answers
    • From screen to answer
    • The BUN trial
    • The FASTER trial
    • The second-trimester genetic ultrasound
    • A clean scan is reassuring too
    • Cell-free DNA screening
    • 91.78%
    • The catch with predictive values
    • How often are major malformations actually seen?
    • Minor markers in everyday practice
    • A soft marker after a negative cfDNA
    • What happens after a marker is found

    13 slides

  5. 05

    Marker by marker

    What each sign is, how to measure it, and how much it shifts the odds

    • Nuchal translucency: what it is
    • Measuring the neck fluid and nasal bone in profile
    • How well does NT perform alone?
    • Where to draw the line
    • Thicker NT, wider problem
    • Defect risk across bands of neck-fluid thickness
    • Risk of Chromosomal and Structural Defects According to the NT Thickness
    • Cystic hygroma
    • Nuchal fold: the strongest second-trimester clue
    • How to measure the nuchal fold
    • Thickened soft tissue behind the fetal head
    • Nuchal fold: the numbers
    • The nasal bone
    • How to image the nasal bone
    • The first-trimester nasal bone view
    • Fetal profile with the nasal bone present
    • Fetal profile with no nasal bone echo
    • Nasal bone: the numbers
    • A small nasal bone counts too
    • Ventriculomegaly
    • Widened fluid space inside the fetal brain
    • Ventriculomegaly: the numbers
    • Echogenic intracardiac focus
    • Bright spot inside a heart chamber
    • Calling it correctly
    • Echogenic focus: the numbers
    • Echogenic bowel
    • Abnormally bright fetal bowel
    • Do not create the finding yourself
    • Echogenic bowel: numbers and look-alikes
    • Pyelectasis
    • Fluid in the fetal renal pelvis
    • Pyelectasis: the numbers
    • Short long bones
    • 11×
    • The weaker markers
    • Where MRI fits

    37 slides

  6. 06

    Look-alikes and what to do next

    Differential diagnosis, counselling and care after delivery

    • Every marker has innocent explanations
    • How screening practice has changed
    • Acting on a second-trimester marker
    • After a confirmed diagnosis
    • After the baby is born
    • What the referring physician needs to know
    • Key points
    • Key points continued
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition

    15 slides