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Re: Lawson: AIUM says thousands of Fetal Photo Places !!!! From: Terry J. DuBose (duboseterryj@uams.edu) Wed Oct 30 10:21:28 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dianne Walkup: "Fetal tissue density" Previous message: art fougner, md: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!" In reply to: Terry J. DuBose: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!" Reply: Terry J. DuBose: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!" Dr. Fougner, you are correct there are many fetal variables, and observations do play a part... that is the reason that I keep thinking that more parameters should give better fetal weight estimates. For example, I noticed several years ago that if the HC/AC ratio indicated that the abdomen was large then a measurement of the liver would indicate some degree of hepatomegaly. I saw this so often that I thought the AC/HC might actually be a good screening for fetal infections or other hepatic conditions. In this scenario, the fetus may actually be ill and IUGR, yet the HC/AC may indicate normal proportions. This has not been tested clinically by anyone, to my knowledge; however, I have speculated about it from time to time. The evaluation of fetal growth/age/proportions and health are very complex and subtle, I realize. However, I think the solutions lie in better methods and more parameters, not less, IMHO. Peace, Terry J DuBose, M.S., RDMS ultrasound@obgyn.net writes: >Terry - > >have observed many with multiple fat lines - others with ones not so >prominent - yet with the same AC's. would think this might play a large >role in error. > >art > >At Mon, 28 Oct 2002, Terry J. DuBose wrote: >> >>Good points... I wonder how much difference there is in fetal tissue density? Would this not be accounted for by regression analysis based upon volumetric measurements? We aren't dealing with weight lifting fetuses on steroids here. >> >>I would think that the age-liver-volume might be a fairly good predictor of overall tissue density... in addition with the abdominal, long bones and cranial volumes we might arrive at some better estimates of weight, ages, and fetal condition (TORCH infections). >> >>If there really is much difference in the fetal tissue density, then more measurements could increase the error. But Hadlock found that more measurements (up to 4) did increase accuracy. >> >>We are just in the infancy of sonography... 25-30 years of general use and equipment development is not much... it will get better. >> >>Peace, Terry J DuBose, M.S., RDMS >> >>ultrasound@obgyn.net writes: >>>not sure about age but i would guess that weight's will always be >>>problematic. first measuring someone's waist line may be predictive but >>>pales in comparison to standing on a scale. additionally, until there's >>>a way to compensate for individual variation in tissue density - eg fat >>>vs muscle content - there will always be errors. >>> >>>more dimensions might actually increase the error. >>> >>>just my opinion - i could be wrong. >>> >>>art >> >>Peace, Terry J. DuBose, M.S., RDMS >>Assistant Professor & Director, Diagnostic Medical Sonography Program >>University of Arkansas for Medical Sciences, CHRP >>4301 West Markham St. Mail Slot #563 >>Little Rock, Arkansas, 72205 USA >>501-686-6510 >>DuBoseTerryJ@UAMS.edu >>http://www.io.com/~dubose/ >>http://www.uams.edu/CHRP/dmshome.htm >>http://www.obgyn.net/us/panel/panel.htm > >-- >art fougner, md >ich bin ein New Yorker > Peace, Terry J. DuBose, M.S., RDMS Assistant Professor & Director, Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot #563 Little Rock, Arkansas, 72205 USA 501-686-6510 DuBoseTerryJ@UAMS.edu http://www.io.com/~dubose/ http://www.uams.edu/CHRP/dmshome.htm http://www.obgyn.net/us/panel/panel.htm Next message: Dianne Walkup: "Fetal tissue density" Previous message: art fougner, md: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!" In reply to: Terry J. DuBose: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!" Reply: Terry J. DuBose: "Re: Lawson: AIUM says thousands of Fetal Photo Places !!!!"

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