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Re: fetal echogenic bowelFrom: Allen Worrall (jworrall@alaska.net)Thu Aug 5 14:51:22 2004
That is my understanding. It is pretty hard to be objective about how echogenic the bowel is. The system that makes the most sense to me: try to obtain an active (non-frozen) view of the bright bowel and nearby bone (usually spine or iliac crest). Hold the transducer in one place and slowly turn down the receiver gain. If the bone fades out before the bowel does, you are probably safe in calling this echogenic bowel. If they both fade out at the same time, maybe it is echogenic bowel. If the bowel fades out and you can still see the bone, it is not echogenic bowel. I am not sure, but I would think that this would hold regardless of the frequency of the transducer you are using. Or to put it as a question: does a higher frequency transducer brighten bone to the same degree as the bowel? I do a lot of transvaginal scanning at 15-16 weeks with the C8-4v transducer, and all those babies have bright bowel. Allen
> ----- Original Message ----- Thanks for the clarification, Allen.
>From a physics perspective, I found it hard to Marveen -- ======================== Allen Worrall wrote: Abnormally echogenic bowel should be as echogenic as nearby bone before you call it echogenic. Allen
> ----- Original Message ----- I've always used variable gain studies to distinguish soft tissue from bone or similar densities. However, the last line of your statement (if I'm interpreting it correctly) implies that fetal bowel is as echogenic (dense and reflective) as bone. Was that your intent? Marveen Craig Tucson, Arizona, USA ========================== =========== Dave Berck wrote: I agree. I also think that echogenic bowel is often diagnosed when it is really not there. I have found the best way is to use a 5MHz transducer and turn down the gain. If the bowel disappears before the bone does, it's not echogenic bowel. --- Allen Worrall <jworrall@alaska.net> wrote: Was the echogenic bowel found on a transvaginal scan using a high frequency transducer? High frequency transducers will make bowel look echogenic. If the fetus swallowed blood, I think that can cause echogenic bowel. The SCREENING tests for Down have indicated low RISK. No DIAGNOSTIC tests have been done, so you do not know for certain that the fetus does not have Down. I think many of the experts (some I hope will respond your message) would agree with the patient's decision not to have an invasive test: I think many would feel that isolated echogenic bowel is not an indication for amniocentesis. Allen Joseph A Worrall MD RDMS OB/GYN Ultrasound at the Fairbanks Clinic Fairbanks, AK 99701 http://www.obgynsono.com
>----- Original Message ----- An ultrasound scan during 18th week of a 29 years old healthy primigravida revealed certain fetal echogenic bowel. No other abnormalities were seen. She had no vaginal bleeding since now. Nuchal translucency on 12th week was <2mm. Triplo test shows 1:10.000 risk for Down syndrome. Serologic tests for congenital infections are negative. The pregnant is not carrier of a known mutation of cystic fibrosis gene. She is not positive to do an amniocentesis for fetal karyotyping. If this embryo has no Down syndrome, not cystic fibrosis, not congenital infection, what else could it has? Dr. Yiannis Nickolidakis Greece http://www.medpages.obgyn.net/geneticsunit.gr ===== David J. Berck, MD, MPH
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