To determine prospectively the value of prone/postprone positioning in the sonographic detection of gallstones, 682 patients were scanned in the recumbent, erect, and prone or postprone positions. The gallbladder was evaluated for an intraluminal hyperechoic focus, shadowing, and gravitational dependence and was identified in 679 patients. Among these, 28% had cholelithiasis. In five cases, prone positioning alone revealed gallstones. In 11 of 140 cases, gravitational dependence was only seen with prone scanning. The gallbladder was seen more frequently when the patients were prone than erect. Prone or postprone scanning is a useful supplement to the gallbladder examination, allowing increased demonstration of gravitational dependence and increased stone detection.
Fetal goiter is a rare disorder, usually associated with maternal thyroid disease. Antenatal diagnosis of fetal goiter is crucial for the immediate postpartum management of these neonates. A case report is presented of an antenatally diagnosed fetal goiter induced by antithyroid medications. Color Doppler was used to demonstrate a high flow pattern that, unlike in the adult goiter, was associated with hypothyroidism in the neonate. A scan of fetal neck region is recommended in patients with current or previous history of thyroid disease, or if neck extension is noted on routine examination of fetal spine.
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