ARDMS and Sonography Canada exam preparation guidelines

Adenomyosis

Hands on training available for any specialities of ultrasounds like abdomen,gynae and obs, obstetric Doppler , Doppler studies, anomaly scan, biophysical profile, superficial structure( thyroid, breast, scrotum),neonatal brain,NT scan , duplex studies, vascular studies,folliculometry,fetal echo etc.

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Umbilical artery Doppler ultrasound

Protocol for NT measurement.

🏷The gestational period must be 11 to 13 weeks and six days.

🏷The fetal crown-rump length should be between 45 and 84mm.

🏷The magnification of the image should be such that the fetal head and thorax occupy the whole screen.

🏷A mid-sagittal view of the face should be obtained. This is defined by the presence of the echogenic tip of the nose and rectangular shape of the palate anteriorly, the translucent diencephalon in the centre and the nuchal membrane posteriorly. Minor deviations from the exact midline plane would cause non-visualization of the tip of the nose and visibility of the maxilla.

🏷The fetus should be in a neutral position, with the head in line with the spine. When the fetal neck is hyperextended the measurement can be falsely increased and when the neck is flexed, the measurement can be falsely decreased.

🏷Care must be taken to distinguish between fetal skin and amnion.

🏷The widest part of translucency must always be measured.

🏷Measurements should be taken with the inner border of the horizontal line of the callipers placed ON the line that defines the nuchal translucency thickness - the crossbar of the calliper should be such that it is hardly visible as it merges with the white line of the border, not in the nuchal fluid.

🏷In magnifying the image (pre or post freeze zoom) it is important to turn the gain down. This avoids the mistake of placing the calliper on the fuzzy edge of the line which causes an underestimate of the nuchal measurement.

🏷During the scan more than one measurement must be taken and the maximum one that meets all the above criteria should be recorded in the database.

🏷The umbilical cord may be round the fetal neck in about 5% of cases and this finding may produce a falsely increased NT. In such cases, the measurements of NT above and below the cord are different and, in the calculation of risk, it is more appropriate to use the average of the two measurements.
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For OBS and gynae exam

Appendix