Mysonores Training & Consultancy - MTC

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Amniotic fluid index

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Greetings & Hi. 💕

Step into the next level of ultrasound expertise. Through expert-led lectures🧑🏻‍⚕️and focused hands-on sessions, participants will learn to scan with confidence, interpret with accuracy, and translate images into meaningful clinical decisions. 🤰🏻

We are inviting you to :
Intermediate - Advanced O&G Ultrasound Course 2026
Beyond The Basics: Precision Ultrasound in Modern Practice in O&G
📍 Venue: Auditorium HTAA, Kuantan
🗓️ Date: 10-12th of April 2026

MOH-employed government doctors may be eligible for a discount. Please email [email protected] for any further information.

Private practitioners who wish to participate in the course may proceed with registration using the link below.
Register now 📝: https://forms.gle/bH9JzecWsyUnvfLK6

Don't miss out on this exceptional opportunity. Secure your spot today. We look forward to see you there.

Ultrasound probe movement

Prenasal Thickness – A small but critically important marker in first-trimester screening for Trisomy 21

In first-trimester ultrasound, in addition to nasal bone assessment and nuchal translucency (NT), an increasingly recognized marker is Prenasal Thickness (PNT).
This represents the soft tissue thickness anterior to the nasal bone, measured between the nasal tip and the overlying skin.

🔍 Normal fetuses:
– Thin prenasal soft tissue
– Normal/long nasal bone
→ PNT / nasal bone length ratio ≈ 0.6

🧬 Trisomy 21:
– Increased prenasal soft tissue thickness
– Shortened nasal bone
→ Ratio > 0.8, indicating a high risk for Trisomy 21

📌 Key advantage:
Using a ratio rather than an isolated measurement helps reduce false-positive rates, particularly in fetuses where nasal bone measurement is technically challenging.
➡️ A single standardized mid-sagittal facial plane can already provide valuable support for the early detection of clinically significant chromosomal abnormalities.

Credit post to nguyenchiphon

What is ARSA?
Instead of arising normally from the right side of the aortic arch, the right subclavian artery takes an aberrant course, passing posterior to the trachea and esophagus, resulting in an abnormal vascular pathway.

📌 Ultrasound clues:
– The pulmonary artery (PA) and aortic arch (AA) are no longer seen in their typical parallel alignment.
– A blood vessel with an off-axis course, looping posteriorly, is visualized — this corresponds to ARSA.
– Color Doppler imaging helps clearly demonstrate the oblique blood flow traveling from posterior to anterior.

💡 Clinical significance:
ARSA may be an isolated finding, but it is also associated with:
– Trisomy 21 (Down syndrome)
– Aortic arch anomalies
– Other congenital heart defects

👉 Therefore, missing ARSA means overlooking an important second-trimester soft marker.

With just a slight adjustment of the transducer, an otherwise hidden vascular anomaly can be revealed.
Correct angle – correct diagnosis.

Credit to nguyenchiphon

Bentong
Raub
Kuala Lipis

Ultrasound private coaching
Jan 2026

Fetal imperforate a**s: When the “target” disappears and a “line” appears
1. Target sign – normal finding
In a normal fetus, the a**s on the transverse plane shows the target sign:
A central hyperechoic ring → a**l ca**l mucosa
A surrounding hypoechoic ring → a**l sphincter muscle
This is a key sign confirming a patent, unobstructed a**s.

2. Line sign – suggestive of imperforate a**s
When the target sign is absent and the a**l region instead shows a linear hyperechoic structure (line sign), this strongly suggests imperforate a**s.
The characteristic round central hyperechoic structure is no longer seen
It is replaced by a linear hyperechoic line representing closed mucosa–rectum
The higher the level of atresia, the more prominent and distinct the line

3. Clinical significance of the line sign
The line sign is not a primary sign; it is used when the target sign cannot be identified
It helps estimate the level of obstruction:
High imperforate a**s → long, clearly defined line sign located higher
Low imperforate a**s → thin or short line sign; a distorted or irregular target sign may occasionally still be present

4. Important diagnostic considerations
A short line sign or an irregular target sign should not be considered normal; low-type imperforate a**s remains possible

Additional evaluation is required, including:
Spine and spinal cord (VACTERL association)
Kidneys and urinary tract
Heart
Sacrum
Third-trimester fetal MRI may aid in classification of the level of atresia.

9 step for fetal heart scan.

Pendaftaran utk sesi private usg workshop 2026 telah dibuka.

Trisomy 21 (Down syndrome) and Cardiovascular Abnormalities on Fetal Ultrasound

Common cardiac and associated markers in fetuses with trisomy 21 include:
(A) AVSD: Complete atrioventricular septal defect.
(B) VSD: Ventricular septal defect.
(C) Linear insertion of the AV valves: Characteristic straight-line attachment of the atrioventricular valves.
(D) ARSA: Aberrant right subclavian artery encircling the trachea.
(E) Echogenic focus: Intracardiac echogenic focus.
(F) Abnormal ductus venosus.
(G) Small thymus.
(H) Pericardial effusion.
These abnormalities help provide early suspicion of Down syndrome during fetal morphology assessment by ultrasound.

Acute cholecystitis




Dm for credit

Retronasal triangle - cleft lip/palate -
1st trimester