Diagnostic Sonography Symposium
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1 S Vanderbilt University School of Medicine Department of Radiology and Radiological Sciences presents The 35th AnnualVanderbilt Diagnostic Sonography Symposium Skyline of Nashville, Tennessee Franklin Marriott Cool Spring Franklin, Tennessee July 23-24, 2011 Sponsored by Vanderbilt University School of Medicine Department of Radiology and Radiological Sciences
2 TABLE OF CONTENTS OBJECTIVES. FACULTY AND STAFF.. DISCLOSURES.. ACCREDITATION... DESIGNATION OF CREDIT COMMERCIAL SUPPORT.... EXHIBITORS..... SATURDAY, JULY 23, 2011 SCHEDULE.... New Ob/Gyn US Techniques and Application (Jacques Abramowicz, MD)... Transperineal Sonography of Pelvic Flow Disorders (Arthur Fleischer, MD).. Sonography in Pelvic Pain (Rochelle Andreotti, MD)... Advances in Fetal Echocardiography (Luis Goncalves, MD) Ob US in Maternal Infections (Jacques Abramowicz, MD).. 3D Ob/Gyn US (Jacques Abramowicz, MD). Instructive Ob/Gyn US Cases (Glynis Sacks, MD)... Ob US MR Correlations (Luis Goncalves, MD)... Neonatal Sonography (Marta Hernanz-Schulman, MD)... Breast Sonography (John Huff, MD)..... SUNDAY, JULY 24, 2011 SCHEDULE Overview of Musculoskeletal Sonography (Levon Nazarian, MD).. Venous Doppler US of Extremities (E. James Andrews, MD).. Sonography of Soft Tissue Masses (Levon Nazarian, MD).. Guided US Procedures (Andrej Lyshchik, MD, PhD)... US of Renal & Liver Transplants (Levon Nazarian, MD) JULY 23-24, 2011 PAGE 1
3 OBJECTIVES After participating in this CME activity, participants should be able to describe and discuss: Indications for use of diagnostic ultrasound in women s health issues and general medical/surgical problems Strategies for interpreting images obtained using diagnostic ultrasound techniques Approaches for developing differential diagnoses for specific women s health issues and general medical/surgical problems covered in this CME activity Challenging issues in diagnostic sonography including musculoskeletal disorders and guided procedures JULY 23-24, 2011 PAGE 2
4 COURSE FACULTY Jacques Abramowicz, MD Professor Director, Ob/Gyn Ultrasound Co-Director, Rush Fetal and Neonatal Medicine Center Rush University Medical Center Chicago, Illinois (Speaker, Live Demo) Rochelle F. Andreotti, MD Professor of Clinical Radiology and Radiological Sciences Associate Professor of Clinical Obstetrics and Gynecology Vanderbilt University School of Medicine Nashville, Tennessee (Co-Director, Moderator, Live Demo, Speaker) E. James Andrews, MD Associate Professor of Clinical Radiology and Radiological Sciences Vanderbilt University School of Medicine Nashville, Tennessee (Speaker) Marilyn Davis, RDMS Clinical Supervisor, Ultrasound Radiology and Radiological Sciences Vanderbilt University School of Medicine Nashville, Tennessee (Planner, Live Demo) Arthur C. Fleischer, MD Professor of Radiology and Radiological Sciences Professor of Obstetrics and Gynecology Vanderbilt University School of Medicine Nashville, Tennessee (Director, Moderator, Speaker) JULY 23-24, 2011 PAGE 3
5 Luis Goncalves, MD Professor Division of Fetal Imaging William Beaumont Hospital Royal Oak, Michigan (Speaker, Live Demo) Marta Hernanz-Schulman, MD Professor of Radiology and Radiological Sciences and Pediatrics Radiology Vice-Chair in Pediatrics Medical Director of Diagnostic Imaging Vanderbilt University School of Medicine Nashville, Tennessee (Speaker) John G. Huff, MD Professor of Clinical Radiology and Radiological Sciences Medical Director, Breast Imaging Vanderbilt University School of Medicine Nashville, Tennessee (Speaker) Andrej Lyshchik, MD, PhD Fellow, Interventional Radiology Radiology and Radiological Sciences Vanderbilt University School of Medicine Nashville, Tennessee (Speaker) Levon N. Nazarian, MD Professor of Radiology and Vice-Chairman for Education Thomas Jefferson University Hospital Philadelphia, Pennsylvania (Speaker, Live Demo) JULY 23-24, 2011 PAGE 4
6 Glynis A. Sacks, MD Professor of Clinical Radiology and Radiological Sciences Associate Professor of Clinical Obstetrics and Gynecology Vanderbilt University School of Medicine Nashville, Tennessee (Moderator, Speaker, Planner) Jill D. Trotter, RDMS Director of School of Diagnostic Sonography Radiology and Radiological Sciences Vanderbilt University School of Medicine Nashville, Tennessee (Moderator, Live Demo, Planner) Phillip K. Williams, RDMS Clinical Supervisor, Ultrasound Radiology and Radiological Sciences Vanderbilt University School of Medicine Nashville, Tennessee (Moderator, Live Demo, Planner) Director and Co-Director Arthur C. Fleischer, MD, Director Rochelle F. Andreotti, MD, Co-Director Planning Committee Glynis A. Sacks, MD Marilyn D. Davis, RDMS Jill D. Trotter, RDMS Phillip K. Williams, RDMS Course Coordinator Vera A. Merriweather JULY 23-24, 2011 PAGE 5
7 FACULTY DISCLOSURE It is the policy of the ACCME and Vanderbilt School of Medicine to require disclosure of financial relationships from individuals in a position to control the content of a CME activity; to identify and resolve conflicts of interest related to those relationships; and to make disclosure information available to the audience prior to the CME activity. Presenters are required to disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentations. All course directors, planners, and speakers have no financial relationships to disclose with the exception of the following: Jacques Abramowicz, MD o Phillips Health Care: Consultant, Speaker s Fee o Siemens: Consultant Luis Goncalves, MD o Philips Healthcare: Speaker s Fee o GE Healthcare: Speaker s Fee o Siemens Medical Systems: Consultant John Huff, MD o Hologic/spouse, Shareholder Levon Nazarian, MD o Editor, Journal of Ultrasound in Medicine, Consultant Vanderbilt CME has determined that there is no conflict of interest. JULY 23-24, 2011 PAGE 6
8 ACCREDITATION Vanderbilt School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. DESIGNATION OF CREDIT Physicians Vanderbilt School of Medicine designates this live activity for a maximum of 11 AMA PRA Category 1 Credit(s) TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. a. To obtain credit for your participation in today s activity, complete the BLUE Vanderbilt CME Documentation of Attendance form. b. Place the completed form on the registration desk as you leave today. c. You will receive notification of online credit availability 1-2 weeks after data is submitted to Vanderbilt CME. d. You may access your record of participation at anytime by visiting the Division of CME web-site at and following the instructions to obtain a transcript. Sonographers This activity has been reviewed by the Society of Diagnostic Medical Sonography (SDMS) and is approved for up to SDMS CME credits. Learners should only claim credit for the sessions they participated in. SDMS CME credits are accepted by both the ARDMS and ARRT. a. To obtain credit for your participation in today s activity, complete the GOLD sonographers CME Documentation of Attendance form. b. Place the completed form on the registration desk as you leave today. c. You will receive notification of online credit availability from cmesupport@sdms.org after data is submitted to SDMS. JULY 23-24, 2011 PAGE 7
9 COMMERCIAL SUPPORT Vanderbilt School of Medicine Department of Radiology and Radiological Sciences expresses appreciation to the following companies for their support of this educational activity by providing unrestricted educational grants: Philips Healthcare Siemens Medical Solutions GE Healthcare Ultrasound JULY 23-24, 2011 PAGE 8
10 EXHIBITORS Vanderbilt School of Medicine Department of Radiology and Radiological Sciences expresses appreciation to the following companies for their support of this educational activity by providing exhibit fees: GE Healthcare Ultrasound Imorgon Medical Lippincott Williams and Wilkins Philips Healthcare Tenvision Ultrasound Zonare Medical Systems, Inc. JULY 23-24, 2011 PAGE 9
11 SATURDAY, JULY 23, 2011 Moderators: Arthur C. Fleischer, MD and Rochelle F. Andreotti, MD 7:15 a.m. Registration/Continental Breakfast Marble 7:45 a.m. Introductory Remarks/Welcome Salon 5 Arthur C. Fleischer, MD 8:00 a.m. New Ob/Gyn US Techniques and Applications Salon 5 Including Safety Considerations Jacques Abramowicz, MD 8:30 a.m. Live Demonstration Salon 5 Jacques Abramowicz, MD Marilyn Davis, RDMS 8:45 a.m. Transperineal Sonography of Pelvic Floor Disorders Salon 5 Arthur C. Fleischer, MD 9:30 a.m. Sonography in Pelvic Pain Salon 5 Rochelle F. Andreotti, MD 10:15 a.m. Break/Exhibits Marble/ Pre-function Salon 5 10:30 a.m. Advances in Fetal Echocardiography Salon 5 Luis Goncalves, MD 11:00 a.m. Live Demonstration Salon 5 Luis Goncalves, MD Jill Trotter, RT(R), RDMS, RVT 11:15 a.m. Ob US in Maternal Infections Salon 5 Jacques Abramowicz, MD 11:45 a.m. Questions/Discussion Salon 5 Faculty JULY 23-24, 2011 PAGE 10
12 Saturday, July 23, 2011 (Continued) 12:00 p.m. Lunch Salons 1-4 Moderators: Glynis Sacks, MD & Jill Trotter, RT(R), RDMS, RVT 1:00 p.m. 3D Ob/Gyn US Salon 5 Jacques Abramowicz, MD 1:30 p.m. Live 3D Volume Set Manipulations Salon 5 Jacques Abramowicz, MD Rochelle F. Andreotti, MD 1:45 p.m. Instructive Ob/Gyn US Cases Salon 5 Glynis Sacks, MD 2:30 p.m. Break Marble/ Pre-function Salon 5 2:45 p.m. Ob US MRI Correlations Salon 5 Luis Goncalves, MD 3:15 p.m. Neonatal Sonography Salon 5 Marta Hernanz-Schulman, MD 4:00 p.m. Breast Sonography Salon 5 John Huff, MD 4:45 p.m. Questions/Discussion Salon 5 Faculty JULY 23-24, 2011 PAGE 11
13 New Ob/Gyn US Techniques and Applications Including Safety Considerations Jacques Abramowicz, MD 1. Describe new technological applications of ultrasound 2. Enumerate applications of xmatrix technology 3. Recognize measures to keep ultrasound safe JULY 23-24, 2011 PAGE 12
14 Transperineal Sonography of Pelvic Floor Disorders Arthur C. Fleischer, MD 1. Discuss the role of Transperineal Sonography in a variety of disorders of the pelvic floor including dysfunction/stress urinary incontinence, uterine prolapse; mesh mishaps ; rectal dysfunction 2. Discuss the technical aspects of TPS 3. Be more knowledgeable of the present and future roles of TPS relative to MR and other imaging modalities used for evaluating pelvic floor disorders JULY 23-24, 2011 PAGE 13
15 Sonography in Pelvic Pain Rochelle F. Andreotti, MD 1. Emphasize the importance of sonography, the imaging modality of choice for the evaluation of suspected gynecological etiologies of pelvic pain. 2. Illustrate the use of US when a non-gynecological etiology of pain is suspected. 3. Illustrate the use of MRI as a problem solving tool. JULY 23-24, 2011 PAGE 14
16 Advances in Fetal Echocardiography Luis Goncalves, MD 1. Have more knowledge of technological advances available clinically for fetal echocardiography 2. Describe the current state of research in the area and how it may be applied clinically 3. Identify knowledge gaps and future research direction JULY 23-24, 2011 PAGE 15
17 Ob US in Maternal Infections Jacques Abramowicz, MD 1. List maternal infections which can affect the fetus 2. Classify sonographic signs of fetal infection 3. Differentiate between various infections, based on fetal findings JULY 23-24, 2011 PAGE 16
18 3D Ob/Gyn US Jacques Abramowicz, MD 1. Appraise the value of 3D ultrasound in daily clinical practice 2. Judge the merits or lack thereof of non-medical ultrasound 3. Identify possible artifacts while performing 3D ultrasound JULY 23-24, 2011 PAGE 17
19 Instructive Ob/Gyn US Cases Glynis Sacks, MD 1. Demonstrate key principles in the sonographic evaluation of certain fetal disorders JULY 23-24, 2011 PAGE 18
20 Ob US MRI Correlations Luis Goncalves, MD 1. Discuss interesting/difficult fetal anomaly cases 2. Compare findings between MRI and ultrasonography 3. Emphasize the complementary nature of both imaging modalities in the diagnostic workup of difficult cases. JULY 23-24, 2011 PAGE 19
21 Neonatal Sonography Marta Hernanz-Schulman, MD 1. Understand the role of sonography in evaluation of pediatric intracranial anomalies 2. Understand the etiology and recognize the sonographic findings in hemorrhagic events 3. Understand the etiology and recognize the sonographic findings in ischemic events in preterm and term infants 4. Appreciate the sonographic findings in infectious conditions affecting the neonatal brain 5. Appreciate the sonographic findings in several of the more frequently encountered congenital anomalies JULY 23-24, 2011 PAGE 20
22 Breast Sonography John Huff, MD 1. Understand the role of sonography in breast cancer screening and diagnosis 2. Choose appropriate technical parameters for breast sonography 3. Characterize a range of cystic and solid lesions in the breast JULY 23-24, 2011 PAGE 21
23 SUNDAY, JULY 24, 2011 Moderators: Arthur C. Fleischer, MD & Phillip Williams, RDMS 7:30 a.m. Registration/Continental Breakfast Marble 8:00 a.m. Overview of Musculoskeletal Sonography Salon 5 Levon Nazarian, MD 8:45 a.m. Live Demonstration Salon 5 Levon Nazarian, MD Phillip Williams, RDMS 9:00 a.m. Venous Doppler US of Extremities Salon 5 E. James Andrews, MD 9:30 a.m. Sonography of Soft Tissue Masses Salon 5 Levon Nazarian, MD 10:15 a.m. Break Marble/ Pre-function Salon 5 10:45 a.m. Guided US Procedures Salon 5 Andrej Lyshchik, MD, PhD 11:15 a.m. US of Renal & Liver Transplants Salon 5 Levon Nazarian, MD 12:00 p.m. Adjourn JULY 23-24, 2011 PAGE 22
24 Overview of Musculoskeletal Sonography Levon Nazarian, MD 1. Discuss the advantages and disadvantages of using ultrasound to image the musculoskeletal system. 2. Describe the normal ultrasound appearance of musculoskeletal structures 3. Identify common musculoskeletal ultrasound pathologies. JULY 23-24, 2011 PAGE 23
25 Venous Doppler US of Extremities E. James Andrews, MD 1. Present sonographic technique for evaluation of the extremities for deep venous thrombosis 2. Discuss risk factors and compare various diagnostic tests for the diagnosis of DVT 3. Develop an algorithm for diagnostic testing including D-dimer JULY 23-24, 2011 PAGE 24
26 Sonography of Soft Tissue Masses Levon Nazarian, MD 1. Discuss the diagnostic approach to soft tissue masses on ultrasound. 2. Describe methods of using US to distinguish cystic from solid soft tissue masses. 3. Describe the use of color Doppler in the differential diagnosis. JULY 23-24, 2011 PAGE 25
27 Guided US Procedures Andrej Lyshchik, MD, PhD 1. Provide overview of current ultrasound guided procedures 2. Discuss potential future clinical applications of interventional sonography JULY 23-24, 2011 PAGE 26
28 US of Renal & Liver Transplants Levon Nazarian, MD 1. Describe the routine sonographic evaluation of hepatic and renal transplants. 2. Identify abnormalities seen on US of renal and hepatic transplants. 3. Discuss how Doppler is useful in evaluating renal and hepatic transplants. JULY 23-24, 2011 PAGE 27
29 JULY 23-24, 2011 PAGE 28
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