STUDENT EXCELLENCE LITERATURE REVIEWHigh resolution ultrasound has allowed increased definition and detailed study of the fetal thorax. From the second trimester, congenital anomalies arising from or involving the fetal chest can be visualized. Early detection and diagnosis of fetal intrathoracic abnormalities are rapidly becoming an integral part of modern obstetrical care and neonatal management. The potential exists to diagnose most intrathoracic anomalies before the 20th week of pregnancy.Although multiple fetal anomalies may be present, fetal lung condition can be a major determinant of fetal viability. Early sonographic detection and assessment of fetal thoracic anomalies are vital for the proper management of pregnancy, delivery, and neonatal treatment. The pleural, pericardial, and. peritoneal cavities are distinct by the second and third trimesters allowing in utero sonographic diagnosis of many pulmonary structural and functional conditions that influence fetal survivability and neonatal outcome.Pulmonary hypoplasia, pleural effusion, cystic adenomatoid malformation, pulmonary sequestra-

Septo-optic dysplasia (de Morsier syndrome) is a rare intracranial malformation characterized by the absence of the septum pellucidum with optic disk hypoplasia. Associated clinical symptoms include hypothalamic-pituitary dysfunction and varying degrees of visual impairment. Although the exact etiopathology is unknown, some researchers postulate that septo-optic dysplasia is the result of a vascular disruption sequence, an environmental anomaly, an autosomal-recessive inheritance, or a genetic abnormality. The associated intracranial malformations with septo-optic dysplasia are agenesis of the corpus callosum, schizencephaly, and lobar holoprosencephaly. To detect septo-optic dysplasia and its associated anomalies, sonographers must scan beyond the routine axial views in utero as well as the standard, neonatal axial, coronal, and sagittal views.

Recent developments in the understanding of the sonographic appearance of the bowel wall, made possible by improvements in ultrasound technology, have given sonography a unique role to play in the evaluation of gastrointestinal lesions. Changes in wall thickness, alterations of normal structures, and complete obliteration of the entire wall structure can be observed. This report reviews the sonographic appearance of the histologic wall structures and shows cases that illustrate how the knowledge of those structures can help the sonographer to evaluate gastrointestinal lesions.

Abdominal sonograms on seven patients with asplenia syndrome and six patients with polysplenia syndrome were retrospectively reviewed. All seven patients with asplenia had a horizontal symmetric configuration of the liver, and three patients had the cardiac apex opposite the stomach. Four of six patients with polysplenia syndrome had a symmetric configuration of the liver, and in five patients the cardiac apex was opposite the stomach. In two of six patients with polysplenia syndrome, multiple spleens were observed sonographically, and the spleen was noted sonographically to be lobulated in three of the patients. The spleen was not visible on at least one sonographic examination in three patients with polysplenia in which the presence of the spleen was subsequently documented. Four patients with polysplenia syndrome showed an interruption of the inferior vena cava. The authors conclude that the knowledgeable sonographer can usually identify the complex abdominal anomalies that are observed in these syndromes if an organized survey of the abdominal organs, particularly the venous structures, is performed. The spleen may be difficult to identify in some patients, and other abdominal anomalies, especially interruption of the interior vena cava can serve as valuable clues that the spleen is probably present, and further search for it is indicated.