Ultrasound Interactive Case Study: MCA Resistance Variability

Ultrasound Case presentation by: Udaya Kumar, MD - May 2000

 

 

History
 
The following scans were obtained from a normal 29wk fetus.

 

Ultrasound Findings
 
The doppler waveforms have changed within three minutes from waveform that had no onward diastolic flow to one that has. This means that a distinct change has occurred in the resistance faced by the MCA (or there is relative vasodilatation). Neither waveform shows "brain favouring effect".

 


(click on pictures for expanded view)

 

Discussion
 
Can anyone on this forum provide an explanation for such a dramatic change in the waveforms?

 

Follow-Up

This 25yr old mother to be was about 31weeks. Cephalic presentation. I wish to highlight, that the MCA waveforms have changed with transducer pressure. RI values have gone up from 0.75 to 0.88 to 0.92 with varying degrees of transducer pressure. On an earlier instance when I saw changing waveforms I was perplexed and could not understand why this happened within a matter of minutes.

 

(click pictures for expanded view)