Table Of ContentSeries Editor
David M. Yousem, MD, MBA
Professor of Radiology
Director of Neuroradiology
Russell H. Morgan Department of Radiology and Radiological Science
The Johns Hopkins Medical Institutions
Baltimore, Maryland
Other Volumes in the CASE REVIEW Series
Brain Imaging, Second Edition
Breast Imaging, Second Edition
Cardiac Imaging
Duke Review of MRI Principles
Emergency Radiology
Gastrointestinal Imaging, Third Edition
General and Vascular Ultrasound, Second Edition
Genitourinary Imaging, Second Edition
Musculoskeletal Imaging, Second Edition
Nuclear Medicine, Second Edition
Pediatric Imaging, Second Edition
Spine Imaging, Second Edition
Thoracic Imaging, Second Edition
Vascular and Interventional Imaging
Karen L. Reuter, MD, FACR John P. McGahan, MD, FACR
Professor of Radiology Professor and Vice Chair of Academic Affairs
Tufts University School of Medicine Director of Abdominal Imaging
Section Head University of California, Davis Health System
Lahey Clinic Medical Center Sacramento, California
Burlington, Massachusetts
C A S E R E V I E W
Obstetric and
Gynecologic
Ultrasound
THIRD EDITION
C A S E R E V I E W S E R I E S
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
OBSTETRIC AND GYNECOLOGIC ULTRASOUND:
CASE REVIEW, THIRD EDITION ISBN: 978-1-4557-4375-9
Copyright © 2013 by Saunders, an imprint of Elsevier Inc.
Copyright © 2007, 2001 by Mosby, an affiliate of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
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Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical treatment
may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluat-
ing and using any information, methods, compounds, or experiments described herein. In using such
information or methods they should be mindful of their own safety and the safety of others, includ-
ing parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their own
experience and knowledge of their patients, to make diagnoses, to determine dosages and the best
treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products, instructions,
or ideas contained in the material herein.
Library of Congress Cataloging-in-Publication Data
Reuter, Karen L.
Obstetric and gynecologic ultrasound : case review/Karen L. Reuter, John P. McGahan. -- 3rd ed.
p. ; cm. -- (Case review series)
Rev. ed. of: Case review. 2nd ed. c2007.
Includes bibliographical references and indexes.
ISBN 978-1-4557-4375-9 (pbk. : alk. paper)
I. McGahan, John P. II. Reuter, Karen L. Case review. III. Title. IV. Series: Case review series.
[DNLM: 1. Genital Diseases, Female--ultrasonography--Examination Questions. 2. Fetal Diseases--
ultrasonography--Examination Questions. 3. Pregnancy Complications--ultrasonography--Examination
Questions. 4. Ultrasonography--Examination Questions. 5. Ultrasonography, Prenatal--Examination
Questions. WP 18.2]
618.107543--dc23 2012041503
Content Strategist: Don Scholz
Content Development Specialist: Gina Donato
Publishing Services Manager: Patricia Tannian
Design Direction: Steven Stave
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To the radiology residents and all those
who participate in the obstetric and
gynecologic care of women
SERIES FOREWORD
I have been very gratified by the popularity and positive feedback that the authors of the Case Review
series have received on the publication of the multiple editions of their volumes. While some are still in
first editions, others have third editions printed and fourth editions in the works. This speaks to the high
quality of the authors and the material they have at their disposal. At the same time, the online versions
available at https://casereviewsonline.com/ offer new capabilities and interaction and self-guided learning
that print editions cannot provide.
David M. Yousem, MD, MBA
viii
BOOK FOREWORD
I congratulate Dr. Karen Reuter for spearheading the third edition of the Obstetric and Gynecologic Ultrasound:
Case Review Series and for pulling in the experience of Dr. John McGahan, a noted educator and outstand-
ing academician. I am happy to see the life span of this volume continue to grow in new ways with new
technologies and new entities. I am sure that trainees and practicing radiologists will appreciate this contri-
bution, as I do, to the Case Review Series. Bravo Karen and John!
David M. Yousem, MD, MBA
ix
PREFACE
This updated third edition of the case review series not only focuses on ultrasound in obstetrics and gyne-
cology but also emphasizes the growing use of MRI in both obstetric and gynecologic imaging. In most
situations, ultrasound is definitive in either documenting normal findings or delineating a specific abnor-
mality. However, in some cases, MRI is useful in collaboration with ultrasound in establishing a diagnosis
or providing other information that may be definitive. This ultrasound case series is in a new format that
includes the use of multiple choice questions with more detailed explanations and discussions including
the most recent medical knowledge. We have provided new cases with updated materials and the latest ref-
erence publications* and cross-references to the newest edition of Ultrasound: The REQUISITES. We hope
you find these cases helpful in your understanding of ultrasound imaging of obstetric and gynecologic
abnormalities for optimal patient care.
Karen L. Reuter, MD, FACR
John P. McGahan, MD, FACR
*Because of space limitations, not all of the references have been included with each case in this book. Additional references are
available at https://casereviewsonline.com/.
xi
ACKNOWLEDGMENTS
A special thank you to my husband, John; Kara and Elias, Kendra and Mark, Kristyn and Jacky (Tin Kei),
and Sophia and her brother Sebastian for their loving support.
KLR
I would like to thank everyone who helped in preparation of this textbook. First and foremost, I’d like to
thank Teresa Victoria, MD, PhD, and Jeffrey C. Hellinger, MD, for supplying many of the magnetic reso-
nance images that helped to make this text useful. Also, I would like to thank Alex Fodor, MD, Jonathan
Kuo, MD, Liina Poder, MD, Simran Sekhon, MD, Holly Thompson, MD, and Luke Wright, MD, who
prepared individual cases for this Case Reviews series. They certainly helped make this journey more enjoy-
able. Finally, I would like to thank those who helped me directly with either illustration preparation or text
preparation including both Hue To and Julie Ostoich. Their hard work made my job much easier.
JPM
xii
