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Wolfgang Kahn

Veterinary Reproductive
Ultrasonography

Horse· Cattle· Sheep· Goat·


Pig· Dog· Cat

English Translation and Revision


Dietrich Volkmann· Robert Kenney

by Dr.Stator & Saraajka


www.vet4arab.co.cc

Wolfgang Kahn

VETERINARY REPRODUCTIVE
ULTRASONOGRAPHY
Horse · CaltJe
Sheep · Goat · Pig
Dog· Cal

,,
I
I
Th.l._ one

I
by Dr.Stator & Saraajka
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VETE NAltY
PRODUCTIVE
I J I Til ASONOGIl APHY
Horse· Cattle
Sheep · Goat · Pig
Dog · Cat

Dr Wolfgang Kahn

Ellglish Trallslatioll alld Revisiol1

Professor Dietrich Volkmann


College of Veterinary Medicine
Cornell University, USA

Professor Robert M Kenney


School of Veterinary Meclicine
University of Pennsylvania, USA

schlutersche
Avk:lrSko Las~ tellO gradivo
by Dr.Stator & Saraajka
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Wolfgang Kahn. Dr. Dr. habil.


Professor
Clinic of Reproductive Medicine. Veterinary Facuhy
University of ZUrich. Switzerland

English Translation and Revision


Robert M Kenney. DVM, PhD
Professor
School of Veterinary Medicine
University of Pennsylvania. USA

Dietrich Volkmann, BVSc. MMed Vet (Gyn)


Associate Professor
College of Veterinary Medicine
Cornell University. USA

0 2004. SchlUtersche Verlagsgesellschaft mbH & Co. KG, Hans·BOc:klcr·Allee 7, 30173 Hannover
E-mail: info@schluetersche.de

Printed in Germany

ISBN 3-89993-005-3
Special edition. Reprint from 1994.
Bibliographic Inronnallon published by Die DeutKbe Blbllothck
Die Deutsche Bibliolhek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic datu an::
available in the Intemetllt http://dnb.ddb.de.
The author assumes no responsibility and males no guarantee for the use of drugs listed in this book. The author I publisher
shall not be held responsible for any damages that might be incurred by the recommended use of drugs or dosages con-
tained within this textbook. In many cases controlled research concerning the use of a given drug in animals is lacking.
This book makes no attempt 10 validnle claims made by nuthors of reports for off-label use of drugs. Practitioners are
urged to follow manufacturers ' recommendations for the use of any drug.
All righl~ reserved. The contents of this book both photographic and textual, may not be reproduced in any form, by print,
pholopnnt. phototransparcncy, microfilm. video, video disc, microfiche. or any other means. nor may it be included in
any computer retrieval system. without written permission from the publisher.
Any person who does any unauthorised act in relation 10 this publication may be liable 10 criminal prosecution and civil
claims for damages.

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Contents
Preface 10 fi rsl ed it jon
Preface 10 current cdilj on

J Ultrasono in the mare ............................................................................................. .


1.1 Techni ue of ultrason in the mare •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• "
J2
1.2 .1
Ovarian slOIctures in the mare "" """ . "" " " """ "" """ " .

Eollicies .. ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,, ,,,,,,,,,,,,,,""""""""''''''''''''''''''',",


""" "". "". """""" " "" " " " "
"
15
15
,'".,2,., ', .,', ______________,So
,',0, es of follicles ...................................................................................... . '5
:'".,2,., ', .,2,_______________,Dcve
"",,', follicles ...............................•....................................•....... '9
:'".:2,., ', .,3,___________" __.T
"m, ,osv
, c,a, inal son uncture of follicles ............................................................. . 23
1.2.2 lutea ......................................................................................................................... . 25
:'".,2,.,"2.,', ______________,SO
". hie ima es o f co fa lutca ............................................................................ . 25
1.2.2.2 Dcvelopmcni of corpora IUlea during the estrous cycle and in earty pregnan9' h .. h, .. . 27
1.2.3 Anovulato luteinized follicles ............................................................................................. . 33
124 Fallio d!!r a nd ova rian he m alOmas 35
1.2.5 Ovarian tumors and IS .............................................. ......................................................... 37
1.3 l lle nne Slructures in Ibe mare"",,"' ",,,,,, W h ." "h'" " " ." , , , . , , , , , , , , . , " " ••• ' " , , , " ' , , , . , " , , . , ' , . , , , . , " " , , , " "", 41
1.3.1 ant uterus •••. " ••• " " ... ".""" .. h .. " ..... " " .. ",,, .... ,, .. ,," ........ ,,h" ........ ,, ..... "h" .. " " ... h". 4'
1.3.2 ant uterus ..... " ..... " .... " ............ " .......................... " ..................... ,..... ,........................... . 43
1.3.2.1 Da 9 to l30f .. " ............. " ...... " ... " " .. " ...... " ...... " ...... " .... " " ........................ .. 43
1.3.2.2 Da 14t0200f ...... " .............. " ..... " .... " ............... h .. " " .... " ....... " .. " .. " ...... ",,. 43
1.3.2.3 Da 21 to 40 of ..................... " ...... " ... "."h" .. h" .... h."" ... " ..... " ... h" .. " " .... " " 49
1.3.2.4 Da .. " ................................. ..... .................... .. .................... " ... .
, , ' ,
5'
1.3.2.5 53
•• • • •• • •

•• •• • •• • •• • ••

•• •• ••
1.3.3.1.1 Head, neck and inal column ................ " ...... " .... " ............. " ................... " ........... .. 6'
1.3.3.1.2 lborax nnd heart "' ..... " .. ".;......................... "' .......... "'''' "... '" '..... "... " .. ""'. "...."' ... . 61
1.3.3.1.3 Abdomen and lvic re on ....... "..... "..... ".... ".... "................................................. . 63
1.3.3.2 Accessibili of e uine fetuses lransrcctal son .. "............. "..... ,".. "" ,... ".. " ..... "". 65
:'".'3~.'3~'.3~~----------"SO ," 0"""'h' ic felomel in horse.c; ................... "..... "..... "..... "........................... "................... . 65
,'".,3~.,3 ~,.,3~,.,'~_____________.E~, and braincase ........ "................... "........... " ..... ".................... " ".... "... " ...... "............ .. 65
1.3.3.3.2 Ribs, trunk and stomach."" ... "" ..,.""""",,,,,,,.,,,,,,,,.,,,, ... ,.,,.... " .. "... ,.... " .. ".. " .. ".. " ...... ,. 67
•• •• • •• •• •• • •• •• •• ••

•• •• •• •• •• •• •• •• •• ••
1.3.4.2 ......................... " ........................ " ............... ..... ...... ,..... .............. , , , , 7'
• • •• •• • • •
• .. .. • .. • • .. .. • .. " • .. .. • 5
" " "
" • "

1.3.4,5 muco- and urometra .. ".................................. "................... ".... " .... " .................... .. 77
~'~.,3,.,4
" .,6, _____, _____,c__.E
" 0,d,,0,,m,e,,',n"·,ai
" IS", .. "" ... "" .... ",.".", ... ",., ... ", .... ", ... ," ... "",.""", .. "", ... ", ...... , .... "",.""" 79
reface., .. ,.. ",.,.,... ,., ................... ,.,." ,..... ,................. ,... ,'.,.,." .... "... ,.. ,.. ,., .. ".. ",, .. ", .. ,.. ,.... "", .... ,." 80
•• • •• •• •• • •• •• •• ••

2 Ultrasono in the cow ... "..... "... "... " h h . . " . . . . . . . . . . . . . . . . . . . " " . ." " " . . " " . . . . . " .... " ..... " " " .. " " 83
2.1 Teehni ue of ultrason in the caw ............. "..... "............................................................. . 83
22 Ovarian Slmctllres in tbe rIl!.V " " . . "" ", " . " " " " " 89
22J Follicles 89
2.2.1.1 Sooo es of follicles "............... "..... ".. " ..... " .. h." " " ......... ", ".". "h ..... " " " .. " " 89

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2.2.1.2 Follicular developmem during the estrous cycle


and in earl ..................................................................................................... 93
22 1 3 Estrous foll jcles 9S
2.2.2 Co ra IUlea ......................................................................................................................... . 95
•• .. ..
IUlea during the estrous 9'cle and in early pregnancy .................................................... 103
.. .. .. • ..
23 I llerine Slnldures in the CCttN 113
2.3. 1 .............................................................................................................. 11 3
.. .. .. .. ..
.. ..
2.3.2.2 Day 21 to 24 of pregnancy ..................................................................... ............. ......... ... 121
2~.~
3~.2~.3'--_ _ _ _~D ""a 25 to 30 of .............................................................................................. 123
2.3.2.4 Da 31 to 400f ..•.............................•............................................................. 127
"2."'
3.,25
,"'--_ _ _ _-'D "'a 41 to 90 of re nan .............................................................................................. 129
2.3.2.6 2nd and 3rd trimester of pregnancy ......................................... ....................................... 133
2.3.2.7 Twin and multi Ie nanctes ....................................................................................... 135
2.3.3 Uterine ................................................................................................................... 137
2.3.3.1 ~b ok death •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 137
23.3.2 Eetal mummification .. .. .. . .. .. .. 117
2.3.3.3 Ectal macemtion ... .. . .... .. . .... .... .. . .... .. . ..
. .. . .. . ... .. 137
2.3.3.4 Po.<' artum uterus ........................................................................................................... 139
2.3.35 Endometriti s .. . .. . .... .. . .. .. .. .. .. .. ) 41
2.3.3.6 -ometra ......................................................................................................................... . 141
2.4 Ultral;Qnography of the bovine fetus ........................................................................................... . 143
2.4.1 Imaging of fetal organs .......................................................................................................... . 143
2.4. !.I Head ... ... " ......... . ... .... .. ................... ............... ." ................... .... ... .... " .... .. " .. .. " ..... ." ... . 145
2.4.1.2 Spinal column ................................................................................................................ .. 153
2.4.1 .3 Neck ... .................. ...... ........... ............. ............. ................. ....... ................... "" ..... .......... ... 157
2.4.1.4 Thorall ..... ..... ...... ...... .. ...... .. " ........ ..... ............. .. " ................ .... ....... . .... ... . . ... ... .... .... ... . . •
" 157
2.4.1.5 Abdomen . " ... . " .. " ... ......... .. .. .. .. ... .... . . . . . . . . " .... .... .... .... .. . .... .. . .. .
" " 159
2.4.1 ·6 Pelvis ... " " ... .......... ... .. .. ..... . ... ..... .... .... .... .... ..... .. . .. . .. . .. . ... 163
2.4. 1.7 From limb ....... ...... ......... .. " ............. ............. ..... ... . ..... . .. ...... . .... .. . "" . . ..... ........... . .. "
" " 163
2 41 8 Hind limb 165
2.4.1.9 Umbilical cord amnion and allantois ••••••••••••••••••••••••••••••••••••••••••• ••••••••••••••••• ••••••••••• • •••
2.4.2 Sex dctcnnjoarjon jn the bovine fetll S .. . .... . .... " .... . ........ . .... ... .... ..... .... .... . ............" " 169
.. .. .. .. .. ..
and their intra·ulerine rcsemations durin ....................................................... 173
2.4.3. 1 arts .................................................. .................................... . J73
.. .. .. .. .. .. .. .. .. ..
.. .. .. • • .. .. .. .. .. .. ..
.. .. .. .. .. .. .. •• .. .. ..
2.4.4.2 Heart frequcn9'. crown-rump-Iength, diameters of
stomach trunk JOCrOtum and umbilical cord ................................. " ...... ............ .. .....
2.4.4.3 Cervical. thoracic, lumbar, coccygeal vertebrae and ribs .............................................. . 179
2.4.4.4 FroD! and bind limbs ..... ...... ..................... .... ................... ..... ...... ................... ....... .... ..... .. 18 1
References to cha ter2 ...................................................................................................................................... 184

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•• •• •• •• ••

3.1 Techni ue of ultrasono c:I<I l.'I •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 187


3.1.1 Transcutaneoll.'I son ............,." ........................-.- ..............•....................................•••••. 187
3.1.2 Transrectal son 189
•• •• •• •• •• •• •• •• •• •• •• ••

•• • •• •• •• • • ••

•• •• •• • •• •• •

•• •• •• •• •• ••

·. •• •• •• •• ·. ••

·. ••

•• •• •• •• •• •• •• •• •• ••
3.3.2.3 Oa)'4O lo lOOofpregnancy ............. ....... ........................................................................ 201
3.3.2.4 Day 100 to 150 ofprcgnancy ......................................................................................... . 205
3.3.2.5 Accuracy of sonographic pregnancy diagnosis ............................................................... 207
3.3.3 Uterine thol ................................................................................................................... 209
References to cha te r 3 ......................................................... ............................................................................. . 210

• •
4 Ultrasono ......................................................................................................... 213
•• •• •• ••

• • •• •• •• •• •• •• •• ·•
.. •• ·•
•• •• • •• •• ••

•• •• •• •• •• •• ••
cysts ...........................................................................................................................
4.3 Uterine structures in .... .......................................................................................................... 219
:4,.,3~,.:I~_____________,N
:eo""' :- , , ,', .".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.____2~,1~9~
"a ", "' ." I,e, ,,,
4.3.2 Pre ant uterus...................................................................................................................... 219
4.3.2. 1 ............................................................................................ 219
• • •• • • • •• •• • •• • •• ••
...............................................................
• • •• •• •• •• ••

•• •• •• •• •• •• ••

5. 1 a"d cats ........................................................................... 227


• • • •• •• • ••

·. ·. ••

·. •• •• ••

•• •• •• •• •• •• •• ••

•• •• •• •• •• ·.
•• •• •• •• •• •• •• •• •• •• •• ••

•• •• • • • •• •• •• • • •• • •• ••
.............................................................................................
5.3.1 .5 Obstetric diagnostics ...................................................................................................... .. 245
5.3.1.6 Postpanum uterus .......................................................................................................... . 245
·. ·. ·.
•• •• •• •• •• ••

•• •• •• •• •• ••

•• •• •• •• ••

Sub'ect index ....................................................................................................................................................... 253

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Preface to fIrst edition


In 1980 it was reported for the first lime that the fetal viability can be detcrmincd allowing a more ra-
ultrasound imaging system· sonogrnphy or B-sean-rcal- tional decision to be made whcn choosing betwecn
time cchogmphy • pcnnittcd a reliable carll' pregnancy mediad or surgical interventions. Also in othcr vet·
diagnosis in mares (Palmer and Driancoun). This reo erinary disciplines thc application of ultrasonography is
pon triggered a de'o'elopment during the course of gaining more importance.
which sonogr.lphy bcaamc an important 1001 for the It is thus becoming apparent that ultrasound diag-
management of reproductive problems. nostics in veterinary medicine may experience the same
Since then sonography provided signifICant contribu- kind of dC\'CIopment as it has in human medicine where
tions to our better understanding of the carty embryonic it was first applied in gynecology at the end of the fifties
phase and has contributed significantly to new discov- (Donald et al. 1958) lind since then has expanded into
cries concerning the function of the uterus and ovaries virtually all fields of diagnostics.
(Chevalier and Palmer 1982. Ginther 1983. Ginther Although the technique currently only stands at the
and Pierson 1984). beginning of its development in veterinary medicine it is
Veterinary sonography has gained significant value ObVKH.L" that ultrasound imaging provides a valuable ad-
in the gynecological examination of mares. In contrast ditional diagnostic tcchnique in gynecological and 0b-
to traditional methods. ultrasonography permits a much stetrical examinations. In the few years of its application
earlier and more accurate diagnosis of pregnancy and this tcchnique has already providcd several new indica-
provides relevant practical information about many tions for diagnostic examinations in normal and patho-
other conditions of the genital trdct (Simpson et a\. logical conditions of the genital tract of domestic ani-
1982. Valan et al. 1982. l..eidl and Kiihn 1984, Kahn mals. When compared to conventional methods the
and l..eidl 1987). diagnostic accuracy has improved significa ntly. too.
Today ultrdsonography is applicd in the reproduc- The sonographic progress provided the stimulus for
tive and obstetrical examination of numerous other spe- writing this book so as to illustrate the possibilities and
cies. Initial publications have appeared on virtually all limitations of the application of ultrasonogmphy to the
domestic species. II has been shown that sonography examination of the reproductive systems in horses, cat-
can be applied "''Cry successfully in the diagnostic v.'Ork- tle, sheep, gool.., pigs, dogs and cats.
up on the bovine utcm" and ovary (Chaffaux et al. J982, I thank my teacher and mentor, Professor Dr. DDr.
Pierson and Ginther 1984 a and b, Reeves et al. 1984, he W. Leidl, for his support and creative guidance of my
Kiihn 1985, Taveme et aI. 1985, White et aI. 1985). In scientific studies over many years. His influence has
countries where sheep and goots are bred intensively, been a significam factor in the development of Ihis
ultrasonography spread surprisingJy rapidJy as a means book.
of diagnosing pregnancy and cstablishing fetal numbers I wish to thank the following people for kindly
(Tainturier et al. 1983 a and b, De Bois and Ta\'Cme providing illustrations and contributions to this book:
1984. Fowler and Wilkins 1984, White et al. 1984). In Dr. C. Bouabid, Dr. J. Fraunholz, Dr. B. Kahn, Dr. T.
the pig ultrasonography is also very useful in diagnosing Pyczak and Dr. K.. Will.
pregnancy (Inaba et al. 1983, Botero et al. 1984, lrie ct I acknowledge the work of the staff of Schlutersche
al. 1984). In the bitch and queen it is used to diagnose in the production of this edition.
pregnancy at a much earlier stage than is possible by any
other method (Mailhae et al. 1980, Boulet 1982, Laiblin
et al. 1982. Legrand et a\. 1982). In obstetrical cases Kaufungen, June 1994 WOLFGANG KAl iN

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Preface to current edition


In 1994, whe n the firs t edition of Veterinary Repro- book was quickly sold out. Both veterinary surgeons and
duc ti ve Ultrnsonogrnphy was published. ultrasound ima- students have frequently requested that it should be
ging was considered to be just a supplementary diagno- reprinted or a new edition published. Looking through
stic 100\. The technique was nOI widely used althal time the first edition. it could be recognised that the book's
and was orten only employed when more convcnlional contents have remained up-t(}-date. Evcn though there
diagnostic 1001s were considered to be inadequllte. In the has been an enormous increase in knowledge about
meantime. diagnostic medical sonography has advanced reprod uctive processes during the more than two decades
to being II basic 1001 used in a variety of physiological of ultrasound imagi ng. the pen.inent basic scienti fic
and pathological reproducti ve conditions in the horse. knowledge had already been included in the first edition.
cow. small rumi nantS. pig. dog and cat. Ultrasou nd ima- and this has retained its validity. Therefore. the publisher
ging has found its way inlo routine veterinary practise for and author have mutually decided to reprint the fi rst edi-
early pregnancy recognition in domestic animal s. fo r tion without changing any of its contents.
improved ovarian diagnosis. and for II better detection of
pathological changes in the uterus.
The extensive impiemcnllllion of diagnostic medical
sonography brought with it a great need for specialist
literature and as a consequence, the first edition of this Zurich. Deccmber 2003 W OLFGANG KA HN

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10 Ultrasollography ill the m(ln!

Flg. 1.1 : Schematic presen tation of the tr;msTl.:ctal ultrasono-


graphy of the: uterus and ovaries of a marc.

"' ig. 1.2: DorR1VCntral sagillul section through the neck of the Fig. 1.3: Oor5O\'cntrnl sagittal section through the body of the
urinary bladder (U) of a marc. The bladde r lies on the hypcr- urinary bladder (arrows) of a marc, The urine is intensely
echoic pelvic floor wide ning as it extends crnnially. The urine echoic, UltrdSOnogram take n with a 5 MHz sector .scanner.
is slightly l'ChQic. Ultrasonogr;lm luken wilh Ii 5 MHz linear
5alnnerl.

t Moo ultr:l.~m~ in this \)001; ""~ laken in ' ivo. Some phol()-
graplt<i ...-en:: made afler §Canning the excised org:tns in a WDleibath
and the Icgt'nds m:ut.ro lK't'OftIingly.

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Uilf'QU}//ogrtlIHIY in lite marc 11

1 Ultrasonography in the mare

1.1 Technique of aUows for the recognition and identirlcation of the


genital organs and their characteristic ultrasonic pat-
u1trasonogJ aphy in the mare tems.
In mares the uterus and ovaries are examined by Feces and fecal ga<; bubbles hinder the transmission
tr.msrcctal ultrasonography. For this pUiposc the ultra- of ultrasound wavcs. The absorption of sound wa\!CS by
sound probe is imroduccd into the caudal rectum. feca l mailer lying tx:twcen the probe's scanning window
In order to keep the probe hygienic and to protect it and the rectal wall will result in the appearance of black
from moisture it is preferable to pull a plastic slccve stripes in the depth of the image, The rectum must
over the probe. The space between the scanning win- therefore be evacuated and the probe then introduced
dow of Ihe probe and the plastic sleeve must be filled through the anus. Thl! probe's scanning window is di-
with gel 10 exclude any air bubbles which cause undesi- rected vcntrally while it slides cr.mially along the rectal
rable reflections and thus affect the image quality. It is floor. During the examination the probe is covered dor-
not necessary to apply any coupling gel tx:twcen the sally by the examiner's hand and manipulated with the
plastic sleeve and the rectum, since he rectum's natural fingers. With increasing experience it is frequently
contractility and moist contents both provide favorable possible 10 determine the position of organs nnd the
conditions for the exclusion of air betv.'een the probe's probe's orientation inside the pelvis by recognizing
scanning surface and the rectal wall. Many veterinarians typical images on the screen. It is usually not necessary
introduce the unprotected probe into the rectum. to manually position the organs in preparation for an
The procedure of ultrasound examination of the ute- ultrasound examination.
rus and ovaries is similar to that of a rectal examination The urinary bladder is the fi~t ullrasoniC'..ally striking
(Fig. I.J). Control and handling of the mare arc also the organ encountered after passing the probe through the
same. Before the genital organs are scanned they are anus. The neck of the bladder widens over the cr..anial
palpated in the usual manner thereby facilitating the pelvic edge to join the body of the bladder (Fig. 1.2).
speedy location of the organs and the correct position- The echogcnicity of mares' urine can vary greatly. The
ing of the probe to ensure a swift and accurate examin- ultrasonic image varies from almost anechoic to
ation. During the leaming period of ultrasound examin· strongly echoic in the case of very viscous urine
ations it is also helpful to compare the familiar palpable (Fig. 1.3), Turbulently moving reflexions can frequen tly
structures to the "new" images seen on the screen. This be detected inside the bladder's fluid content.

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12 Ultmsonogmph), in tile mUn!

A
B
HI . 1.4: Trnn~"'1:rse section through a uterine hom of a marc. fig. 1.5: Schematic presentation of a traflSVCrse section
1lIc peritoneal bordelS are indicated by anu.....s. Analogous to throogh a uterine hom (A) and a longitudinal section through
the sc..'Ction represented by A in Fig. 1.5. thc utcrine body (8).

fig. 1.6: longitudinal section through the uterine body of a .'Ig. 1.7: Trans\"ersesection through a utcrinc hom (aITO'l'o"S) of
marc equivnlcnt to the section illustrated by B in Fig. 1.5. The a nonpregnan t mare. The uterus is positioned ahlJ\1: 3 arched
OO/S3J and ventral uterine bordclS arc demarcated by large sacculations of the left dorsal colon. The difference in impcd-
arrows. The opposing surfaces of the endometrium form an aocc bc",,'cen the intestinal wall and the feces cau...-.e total
echoic line (small 3rf01.\"S). rcfkction of the ultrasound \\'lln':S along the echoic saccula·
tions of the oolon.

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Techlliqlle of IIltrasOIlOgraphy t3

After visualization of the urinary bladder the ultra· domen, usually ventral to the left uterine hom, repre-
sound probe is advanced cranially until the uterus ap- sent the sacculations of the left dorsal colon. The drastic
pears on the screen. The probe is placed dorsally on the change in impedance betv,.een the gut wall and the gas
uterus at the level of the bifurcation. From here the conlaining feces underneath it cause the total reflection
ventrally directed probe is rotated laterally along the of the ultrasound waves. The thin wall of the colon thus
uterine hom until the ovary is visualized and then back appears as a wavy structure of high cchogenicity. The
to the opposite side to the second ovary. In this manner deeper areas are not reached by enough ultrasound
the uterine horns are scanned slice by slkc. Each slice waves and therefore remain almost totally dark. The
represents a sagittally oriented cross section through the bony pelvic floor also presents as a hypcrechoie struc-
uterine hom (Fig. 1.4 and 1.5). After the two horns the ture (Fig. 1.2). It is recognizable as anechoic line caudal
uterine body is imaged on the screen. Starting at the bi- and ventral to the uterus and the urinary bladder.
furcation the probe is withdrawn along the midline up In addition to transrectal ultrasonography, trans-
to the level of the cervix. In the process one sees a sagit- cutaneous ultrasonography can be applied in mares.
tal longitudinal section of the uterine bexly (Fig. 1.5 and The transcutaneous approach is less established for rou-
1.6). During the course of an examination the probe line gynecological diagnostics than the transrectal
should be moved rather slowly so as to ensure that the method. One valuable indication is the visualization of
entire uterine tract as well as the ovaries and their func- the fetus and its uterine environment during the second
tional structures can be assessed. It is important to be and third trimesters of pregnancy (ADAMS-BRENDE-
aware that only a minor rotation of the probe results in MUEHLand PIPERS 1987). Since the hair on the abdomi-
a significant shift of the scanning plane in the depth of nal wall prevents the penetration of the ultrasound
the field . A 30 degree rotation of the probe results in a waves, the mare's \-entral abdominal hair must be
5 em movement of the scanning plane at a depth of IO thoroughly clipped very well before perfonning the
em. Fast probe movements and motility of the targeted ultrasound examination. The majority of mares tolerate
organs can be additive with the result that important the transcutaneous examination less well than the trans-
features are passed too quickJy or even missed. rectal procedure.
Organs closely associated with the internal genitalia
can be used as reference points to improve one's topo-
graphical orientation. Very echoic arches in the left ab-

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14 U/lr(lSollography ill the ilia"

rel."vt: echo
rnhanccmcnt (E)

$hadows (S)
rag. 1.8: Schematic illuslnttion of the ultrasonogmphy of a 1.9: Ultrasonogram of an estrous follicle in a man: anaJo..
fo~",
nuid fillt.'tI \'csicle. A • oblique W'd\'1,: impact. b • perpendic. gous to the schematic representation shown in Fig I.S. C •
ular wave imp.'1Cl. c • tangen tial wave impact. D - hype r· tangential ......d\'e cntl)'. D - h)'percchoic distal wall with
echoic distal wall, E • relalr.'C echo enhllllCCffiCnt, S • shad· specular reflection. E - rela tive echo enhancc:mcnl. S - shad-
ow ar1i raCl.~ ow artiraCl.~.

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Follicles 15

1.2 Ovarian .II uctures in the mare liquely onto a perfectly level border surface they would
all be deflected and no signals ,,"'Ould be received
1.2.1 Follicles (HAssLER 1984). Bordering layers in the body are, how-
C\'Cr. irregular and a varying number of sound waves are
1.2.1.1 Sonographk images .rrollieles always reflected back to the transducer. Where the
sound waves hit the follicular wallo; at a tangent, they are
. The ultrasonic image of follicles exhibits fea tures largely deflected (Fig 1.8 and 1.9) with hardly any echo
characteristic for fluid filled vesicles. signals reaching the probe from such sites. Very few
Some of the components of the image can be related sound waves continue to progress in a straight line from
to the presence of real morphological structures of the these sites into deeper tissues. The vast bulk of the
follicle (KAliN and UIDL 1987 b), while some ultrasonic ultrasound energy is dellected laterally from here. The
image patterns typical for follicles are induced by phys- result is that narrow. sometimes slightly widening, echo
ical phenomena when ultrasound waves impact onto shadows fonn below such areas of tangential ..'iOund
vesicles and their fluid contents. They are thus seen as wave impact
principal features whieh are referred to a... artifacts. Amplified echoes or brighter images arc seen behind
These image components which result from the inter- larger fluid filled vesicles (Fig 1.8 and 1.9). Ultrll<iQund
action between ultrasound waves and flu id filled ves- is much less attenuatcd by fluid thiln by ot her body tis-
icles frequently do not reflect the presence of actual sues. When sound wa,'CS penetrate larger fluid bodies
tissue components and should be viewed as artificial they reach the deeper lying tissues with more energy
products. An understanding of their origin helps to and cast a much more intense l'Cho than neighboring
a\'Oid misinterpretations and permits proper conclu- waves thilt folloYt'cd a longer path through layers of tis-
sions about the nature of a vesicle. sue with more wave absorbency. Also on its p.1th back
When ultrasound waves impact vertically onto a towards the transducer the reflected ult rasound penet-
smooth reflection surface . some waves are reflected rating through fluid looses less energy :md is ilbsorbed
back to the transducer and are depicted as an intense to a lesser extent. This creates the impression of an
echo on the screen (Fig 1.8). 1he echogenicity is strong- echogenkity behind a fluid filled vesiclc. the so C".lIled
est where the ultrasound waves fall perpendicularly enhancement artifact. The width of the enhancement
onto the front and baek "''ails of the vesicle (Fig t .9) area is detennincd by the diameter of the fluid filled
which result in specular reflections. In the area where body. laterally. the rlCld of echo enhancement is usually
the ultrasound waves fall obliquely onto the follicle wall demarcated by the narrow ultrasonic shadows which
a smal1er amount of the energy is reflected, the remain- originate from where the .sound W'dVCS impaCl tangen-
der being deflected away from the transducer and nol tially onto the latcral walls of the flu id body.
received. At these sites the follicular W'dlJ is less echoic
and thus dllrker. If the sound waves were to fall Db-

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16 UltrosOilogrophy ill the mare

Fig. 1.10: Ovary of an estrous mare ....ith follidcs of varying f1&. 1./1 : Ovarian rallKles of a mare. A small follicle is indent-
shapes. Four small round folliclcs and one large polygonal fol- ing the ....1\11 of a larger estrous follicle.
lide of estrus can be diSlinguislu:d.

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Poflicles 17

The ultrasonic image of a follicle in cross section is WiWes imp<lct vertically onlO the front and back walls of
seen as an anechoic area on the monitor. The lalter can the follicle (Fig. 1.9 and 1.10). Laterally to this line the
be delineated by a narrow brighter line which follows echogenicity is reduced along the obliquely oriented
the outline of the follicle. The anechoic nature of the w:llls. The echo intensity in Ihis area is comparable 10
follicle is caused by the lack of reflection of sound waves that of moderately dense tissue and is hardly distinguiSh-
as they travel through the relatively cell free , clear folli- able from the surrounding stroma. In the region of lan-
cular l1uid. Occasionally, and partkularly in larger fol- gential wave impact the follicular wall is usually not visi·
licles, there will be clumps of reflexions visible close to ble. TIlCSC areas arc frequently marked by the origins of
the follicular ",-all. The shupe of follicles varies (rom the shadow artif:lcts that begin here and stretch into the
circular to oval to irregularly polygonal to nearly angu- depth of the image.
lar (Fig. 1.10). These variations in shape arc the result The echo enhancement of the tissul.'S behind larger
of differences in pressure between neighboring folli- follicles is one of their typical features . The size of this
cles, corpora lutea or even the ovarian stroma itself enhancement area is correlated wilh the size of the fol·
(GINTHER and PtERSON 1984 a). When adjacent fol- licle.
licles are of equal pressure their adjoining walls are Using ultrasound at a frequency of 3.5 MHz one can
often completely slmighl. In contrdSt. small follicles of relatively reliably detect follicles that are 6 to 8 mm in
high inner pressure may clearly bulge into the lumen of size, but with ultrasound at 5.0 MHz follicles of 3 10
larger. softer follicl es (Fig. 1.11 ). When the ovary 5 mm are delectable with relative ease (PAL\IER and
contains numerous small. tense follicles its ultrasound DRIANCOU RT 1980, GINTIIER and PIERSON 1984 b).
image may resemble a honeycomb.
The follicular W"dll is hypcrcchoic and thin. A narrow
hypcreehoic line is often visible where the ultmsound

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18 Ultrasonography ill the marc

Largest follicle

'0 30
+
Ovulation

~
r rf'l nIII I-I I I I III
Q 10 5eeond l:ugest follicle

o -li("I~'''I~'''I~'''lr'''lr'''lr'''I~'''I~.,1
-192 · 168
I ·' I ~
_]44 . ]2(1
I ·S 14 I
-96
·S
Time before ovulation
·n -48
I ·S I ., I , I
·24
0.,.
0 Hours

Fig. 1. 12: GfUI.\1h of the eSITous follicle and Ihe second largest .' ig. 1.13: Two estrous follicles in a mare shortly prior 10
follicle during the prroo.·uJUlo ry period in mares (meun:j; SD: double ovulation. Theirdiameters arc bct....-een 35 and 37 mm.
adapted from WIt.!.et aI.1988).

• " Round follicles


-0- " (}"al foJliclc$
80
• " Irrtgulnrfollicles
10

Ovulation

00
0 ,, 1 1
... 1
·n ..,
1
4 8 .S6
1
,
.", I 0.,.
· 120 ·108 ·96
I 4 I ~ I ·s I ., ·2~

I
Houn

Time before o\'ulalion


1-". 1.14: Omngcs in shape of estrous follicles during the rig. 1. 15: Irregularly shaped estrous follicle in a mare shonly
preowl:ltory period in mares (adapted from WIl.l. et al. before ovulation. Its largest diameter measuR.'5 53 mm (be·
1988). .....·CCII markings).

d
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Po/licles 19

1.2.1.2 Developmenl of preovu lmory follicles In many of the more mature preovulutory follicles
one can see a change in shape during the days preceding
Approximately J92 hours before ovulation (Day -7: ovulation (WIU_el at 1988). The majorily of dominant
Dayofovulation · OayOorDayOoftheCycle)domi- follicles are distinctly round 3 or more da)'5 before ovu-
nant estrous follicles hu\'C a mean diameter of about 25 lation (Fig. 1.14). During the days until ovulation the
mm (Fig. 1.12). They lhen grow al 2 10 2.5 mm per day estrous follicle will change to a more oval or irregular
and rtuch their maximum diameter of 41 1045 mm al shape (Fig. 1.15). On the day of ovulation only about
24 to 48 hours before ovulation ( P IERSON and Gtllol1 tER one third of the estrous follicles will be round in shape.
1985 b. WIll. et al. 1988). In mosl cases no further Apart from the palpable feature of follicular coll.'iis-
growth occurs during the lasl I 10 2 days before ovu- tenC)'. the ultr.lSOnic shape nnd size of a follicle can be
lution ( PAU1ER and DRIANOOURT 1980). The diameter utilized to help predict the time of an impending ovulll-
of the preovulatory follicle often remuins Slatic; some- tion. Other pammeters. such as the thickness of the fol-
limes even a reduction in the diameter can be measured liculnr wall or the I..'chogenicity of the follicular contenlS
on the day of ovulation. have been shown to be of little value. If the largcst fol-
AI the time of ovulation of a single follicle it will !icle shows an irregulnr shupe. is til lea.'> t 40 mm in size
usually hm'c a diameter of 40 mm or more. Only occa- and has possibly been shown to hu\'C stopped growing
sionally will follicles be smaller althe lime of ovulation. for some time one should ~pect ovulation to occur very
The upper limit of the size of normnl ovulatory folliclcs soon. Although sonography hlL'i contributed meaning-
lies between 55 and 58 mOl. fully 10 the prediction of the timc of ovulation its value
When doublc ovulations occur the diameter of the with regard to the aCCUnlC)' of such predictions must not
preovulatory follicles muy be smaller than those of be O'o'ercstimated. When manual criteria are combined
single follicles (Fig. 1.13). In these C'.tSCS ovulntion of with those of ultm.sonogmphy it is possible to correctly
follicles with diameters of between 35 and 40 mOl are predict about one third of the ovulations that will occur
nOI unoommon . during Ihe next 0 to 12 hours (WILL et at 1988).

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20 UJtrasollograpl,y ill the man:

Fig. 1.16: Collapsed follicle immediately after ovulation. The .-130 1.17: Collapsed follicle on the day of ovulation slloYiing a
follicle still conlains small amounlS of residual fluid (bctv.'eCn bro.1d echoic scam (arrows) in the area of the original follicu-
the cros.scs). lar w.1l1. The center contains anechoic fluid.

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Follicles 21

An ovulation can be recognized ultrasonically when quantities of residual fluid . Whether the anechoic fluid
a folliclc that was still present a short time ago cannot be in the lumen of the follicle consists of follicular flu id or
found at a subsequent examination. Ovulation itself blood, which acrumulates inside the follicu lar lumen
usually only lakes second<; to minutes (CARNEVAlE el al. after ovulation, or a mixture of both, is unclear.
1988 b). The actual collapsing of the ovulating follicle in many cases immediately after ovulation a large
can only be demonstrated by chance if the nlare is ex- echogenicity is detectable near the collapsed follicular
amincd \!CI)' frequenlly (Fig. 1.16 and 1.17). The wall of wall and may fill the entire area of the original follicle
the follicle appears to fold iny.-ards, the follicu lar cavity (sec also Chapter 1,2.2.2).
i<; irregular in shape and sometimes contains small

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22 UilroSOllugroIJI'),;/1 (he ImllY'

)Ol g. 1.18: Tmn~".ginlll 'iOnogr.lphic puncture of lin CStrous .-ig. 1.19: U lt ra~nogram depK.1ing the hcmo rrhagc (be.
folliclc of a mare follo\.\·cd by the aspiration of the follicular "''Ccn the dol~) into a follicle 3 minutes after a puncture had
Ouid. lbc puncture needle enn be secn bc",-ccn the two guid· been performed. The real time image dea rly ~'cd turbu-
mg linC!> and rl:ache~ llppruximlltely J on into thl: follK:U lar IeIKCS (arTOYo) inside the accumulated blood iIIusU"ating the
tmtrum. inflow of more blood.

Jolg. 1.20: Corpus lutcum (:lrTOYo"S) which dC\elopcd at thc site


of B follicle th:u had been puncturt.'tl -I days pn.'"ViousIy.

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Follicles 23

1.2_1.3 Transvaginal sonographic (Fig. 1.19). Within only a few minutes the follicular cav-
puncture of foll icles ity filled with blood whieh exhibited intensive echoge-
nicity. Within this hemorrhage. turbulences, indicative
Tranwaginal follide punctures can be used to collect of the streaming of blood into the follicle, .....ere seen o n
nuid from preovulatory fo llicles or to attempt the the TCIII-time ultrasound imllge. The extent of hemor-
collection of OOC)'Ics. The same instrumentation that rhage was similar to thllt seen lit the site of the future
was designed for tr,lnsvaginal conceptus punctures was corpus lutcum after spontaneous ovulations (sec Chap-
applied for this purpose (see Chapter 1.3.2.6) using a ter 1.2.2.2). Thus far no disorders have been observed
similar technique. The automated puncture device. cov- in mares after follicle puncture.
ered by a protective plastic sleeve, was introduced into When the puncture site was examined ultrasonically
the anterior vagina where it was gently pushed ag.1inst during the next few days, the formation of a structure
the vaginal wall. Using II rectally introduced hand. the not unlike that of a corpus Imeum could be obselYCd
ovary was the n brought towards the lip of the ultra- (Fig. 1.20). A single puncture of a follicle shonly before
sound prolx:. When it was evident on the monitor that its anticipated ovul3lion did not affect the development
the follicle was aligned in the direction of and fo r the of a normal corpus luteum thereafter (CARNEVALE et
correct depth of the puncture needle the automatic al. 1988 a). In some mares whose follicles were punctu·
puncture device could be triggered (Fig. 1.18). red, lowe r plasma progesterone concentrations were
Using thi.<; technique it was jX)S.<;ible to aspirate folli- measured during the first 3 to 5 days after punc-
cular nuid. Using a double barreled needle it wa.<; pos.<;- ture than in mares that ovulated without interference.
ible to continuously nush a follicle; with a single bar- This difference in progesterone secretion was, however,
reled needle follicles could be filled and the nushing not evident after Day 8 of the cycle. Cycle length and
fluid aspirated repeatedly. the ensuing estrus of mares ....'eTC nOl affected by follicle
Immediately after a follicle had been punctured it puncture.
was evident that intmfollicular hemorrhage occurred

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24 Ultrasollography ill the man!

."!g. 1.21: Solid corpus I"tcum (dots) bc ~'CCn SC\ICraJ small


follicles on the ovary (arro...;s) of a mare. A hypocchoic bor-
de r zone scfXIrdtcs the corpus lutcum from the surrounding
ovarian fXIrench)ma.

fig. 1.2.2: Ultrnsonogrnm of a regressing corpus luteum (ar- FiI. 1.23: Section through an OVllry that was rerTlO\-..-d by
1"tJ\II"S) next to an estrous follicle. Analogous to the sectioned ()'I,'aricctomy from an estrous mare. A small remnan t of
ovary in Fig. 1.23. The inner diameter of the follicle is ap- hemorrhage is still "isible in the center of the regressi ng cor-
proximately]S mm. pus lmeum (arT"OYl"S). To the left of the corpus Imeum lies the
an trum of ttt.! estrous follicle .

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Corpora lutea 25

1.2.2 Corpora lutea cases, sometimes even cubical. It is often narrower ncar
its center, resulting in a pear shape. Frequently. vesicles
1.2.2. J Sonographic images which lie adjacent to the corpus luteum are the cause of
of corpora lutea these indentations to the outline of the corpus luteum.
When 5 MHz scanners are used corpora lutea are
Useful ultrasonic features in identifying a corpus relatively reliably detectable from their formation until
luteum are its characteristic echogenicity, its size and middiestrus around Day 12 of the cycle (PIERSON and
shape, as well as a thin hypocchoic border zone which GINll-tER 1985 a). Thereafter they become less distinct.
sepamtes it [rom the surrounding ovarian parenchyma AI the time of luteolysis., approximately 14 to 16 days
(Fig. 1.21). On ultrasound, luteal tissue shOW'S up in after ovulation, they are still detectable in many
varying gray tones which are typical of the reflections instances. Only rarely can the regressing corpus IUleum
received from loose, moderately dense tissue. The sur· be identified with certainty at the time of the following
rounding ovarian parenchyma is more echogenic, due ovulation or even a few days later (GIl\'1l-fER and PIER·
to its higher density and it contains many anechoic fol- SON 1984 b). By this time it will have become signif·
licles. The shape of a corpus luteum is irregular in many icanlly smaller (Fig. 1.22 and 1.23).

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26 Ultrasonography in lite mare

t-1g. 1.24: Intense echogenicity (alTOYo'S) at the site of the est· Fig. 1.25: Sectioned w.IIY J days afler ovulation !;hov-ing a
rous follicle one day afte r ovulation. The bright cchogenic:ity is young corpus luteum in its center.
caused by the hemorrhage into the follicular antrum afterovu-
lation.

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Corpora Ilt/ea 27

1.2.2.2 Development of corpora lutea during fonner follicles can also be secn after iatrogenically
the estrous cycle and in early pregnancy induced hemorrhages during follicular punctures (see
Chapter 1.2.1.3 and FIG. 1.19).
The site of the development of a oorpus luteum can The hemorrhagic area of young oorpora lutea re-
already be recognized by its intense ultrasonic cchogen- mains vcry echoic for the first 3 to 4 days following ovu-
icity within the first 24 hours after ovulation (Fig. 1.24). lation (PAL\IER and DRIANCOURT 1980). This hyper-
In some rases this site can even be detected within echogenicity is only detectable for a short lime after
minutes after ovulation (GINTIIER and PIERSON 1984 a, ovulation, because with the increasing proliferation of
KAHN and LEIDL 1987 b). These intense reflections luteal cells in the area of the blood clot it beoomes less
originate from the hemorrhage into the follicular lumen echoic. This process of luteinization usually progl\..~
which occurs after ovulation (A ll EN el al. 1987). The so rapidly, that large areas of the blood clot are taken
development of such hyperechoie areas at the sites of over by Imeal tissue (Fig. 1.25).

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28 Ultrasonography in ti,e mare

f'II. 1.26: A solid corpus tUleum (arruv.'S ) in a mare 8 days post Fig. 1.27: Hemorrhagic corpus lmeum (alTOYo'S) of a marc 3
ovulation. To ics righ t is a follicle (between crosses) wi th a dia· days post ovul!llion. The narrow, h)pcrt.'Choic edge of luteal
meIer o f 24 mm. ti.<sue surrounds the large. hypocchoic ccntral area of the
blood dol.

f'II. 1.28: Sectioned ovary of a mare contammg a corpus


hemorrhagicum. The luteinization progresses from the
periphery IOwards the ccmer of the blood dot.

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Corpora flliea 29

Two kinds of corpora lutea can be distinguished appearance: A hypcrechoic peripheral edge and a cen·
during the diestrus in mares: Compact corpora lutea tral. less echoic core arca (Fig. 1.27). In the lattcr the
and hemo rrhagic oorpora lulea (PIERSON and GtNlliER echoes vary from hypocchoic to almost anechoic and
1985 a). A solid corpus luteum develops in about half of nol infrequently they form trabecular, web like patterns.
all mares after ovulation while in the other half a corpus These two zones of corpora hemorrhagica result from
hemorrhagicum fonns. No functional difference ap- the echoic peripheral zone of luteinized tissue and the
pears to exist between the t....,o types of corpora lutea hypocchoic central zone of the blood clOI, respectively
(TOWNSON et al. 1989). Both, progesterone concentra· (Fig. 1.28). The blood clot reflects ultrasound less
tions and cyclic events, are the same in mares with a cor· strongly than the luteinized wall and is sometimes
pus luteum or a oorpus hemorrhagicum. Knowledge of traversed by a nel\"'Ork of fibrin.
the typical appearance of a corpus luteum is, however. After ovulation, the entire cross sections of almost
imponant for its correct ultrasonic identification. all hemorrhagic oorpora lutea are echoic (PIERSON and
Solid oorpora lutea have a homogenous echogenicity Gll'm-l.ER 1985 a). Only after a few days can the hypo-
and structure acrms their entire cross sectional surface echoic central area be distinguished from the more
when viewed by ultrasonography (Fig. 1.26). The entire echoic peripheral area. On the third day of the cycle of·
compact corpus luteum seems to consist of tissue of ten less Ihan half of the cross sectional surface area of a
equal echogenicity throughout. They retain the same oorpus IUleum consists of echoic luteinized tissue (Fig.
echogenicity for the duration of diestrus. 1.27). As the cycle progresses the echoic areas enlarge;
The second form of corpora lutea, the corpus hem· by Day 9 of the cycle they make up about 70 %, by the
orrhagicum, consists of two distinct zones of differing end of the cycle usually 100 %, of the corpus luteum.

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30 UllrllsonogrtllJhy in the mare

fig. 1.29: Corpus IlIleum of prcgnalK)' (a~'S) in a marc on fig. 1.30: Two rorporn IuIca (a~""S) on Ihc ovary of a marc
Day 17 of gCSlalion. ·'be corpus Imeum is surrounded by sev· on Day 25 of gC5talion. Dclow Ihc corpora IUlca lies a follicle .
eral follicles.

"'g. 1.31: Co rpus hcmorrhagkum (arrows) in II marc on Day "1g. 1.32: Two oorpora lulea (1I~""s) in II marc on 1>.1)' 116 of
53 of gC!llation. gcslalion.

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Corpora {Idea 31

Once conception has occurred the primary corpus Also Ihe accessory corpora lutea of prcgnllncy which
luteum of pregnancy remains detectable during the develop between Days 40 and 60 of gcstation can be
cour.;c of early gestation (Fig. 1.29). The same two demonstrated by ultrasonography. Among these acces-
forms of corpora lutea that are seen in diestrus can be sory corpora lutea of pregnancy are some that have the
found during the finit two ","'Ceks of pregnancy. When same appearance as the corpora hemorrhagkn whieh
the corpus luteum of pregnancy reaches a few weeks of occur during the nonpregnant cycle (Fig. 1.27). In the
age it usually has the same homogenous cchogenicity as beginning these show a narrow peripheral edge which
is typical of the solid corpus luteum of the cycle. surrounds the trabecular hypocchoie central area (Fig.
After a double ovulalion has laken place, both oor- 1.3 1). During the further cour.;c of pregnancy the cen-
pora lutea can be depicted. Also in the case of an early tral, less echoic area becomes smaller while the hyper-
twin pregnancy it is possible to depict both corpora lu- echoic luteinized wall grows thicker (Fig. 1.32).
tea (Fig. 1.30).

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32 Ultruso/logrophy in the mare

tia. I.J3: Anovulillory. luteinizing follicle (between the cr0s- "1;. 1.34: Anovulatory. luteinizing follicle (arrows) from Fig.
ses) wi th a ne r.o'ork of internal echoes and a thin luteinized 1.33 seven days later. TIle luteinized pcriphernl area sur-
wall (arrows). TIle size of the follicle W.IS 81 x 81 mm and the rounding the hypocchoic center has become subsllinlially
plasma progesterone roncc ntrn tion in the marc was 5.1 nglml. wide r. The plasma progesterone ronccn tr.ltion of the mu rc
was 1.6 nglml.

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AIIOI'II/OIOf)' follicles 33

1.2.3 Anovulatol)lluteinized follicles wider (Fig. 1.34). The funher dc-."CIopment of these
structUI'CS resemble that normally seen in hemorrhagic
Occasionally during an estrus a \'l'sicle will develop corpor.. lutea during the course of diestrus. The lutein·
into a dominanl follicle. but will not ovulate. Such ano- ized wall that sUlTOUnds the hemorrhagic center be·
vulatory folliclcs sometimcs have the same size as that comes wider while the central. hypocchoic area shrinks.
of normal. mlllurc preovulatory follicles (WIU. et al. Some of the anovulatory follicles therefore seem to lute-
1988). Orten they grow to larger diametcn> of 6 to 10 inize to develop into slructures similar to carpor.! lutea.
centimete"" and rarely even larger. Some of these ano- This obscrvlItion is supponed by the plasmll pro-
vulatory follicles seem to develop into hemorrhagic fol· gesterone conccnlrotions in these mares. In some indi-
licles, whereas others show clear signs of lutcinizatK>O vidual cases it has been possible to demoll5lmte rising
(SoUIRES et at J988, LEIDL and KAHN 1989). plasma progesterone conccnlrations at the time when
During cstrus. the sonographic appcaronce of ano- the fir.;t hYJX!rechoic foci appeared in the follicle.
vulatory follicles correlates v.'ell with that of normal fol- Ouring lhe course of the development of the luteinized
liclc.'i. In those follicles that will later develop signs of structure the plasma progesterone concentrations
luteinization. reflections will appear with increasing fre- rellched the expected levels and the ensuing estn.LS
quency at a lime shonly arter ovulation would have occurred at the normal lime.
normally taken place (Fig 1.33). These lr.werse the Similar pictures as have been described for anovula·
hypocchoic follicular lumen in the form of I1occulation tory. luteinizing follicles during the estrous cycle could
and/or networks of hypcrechoic reflections. These also be seen during early pregnancy (Fig. 1.31). At 40 10
echoes may originate from the bloody follicular con- 50 days of gcstation. at the lime when the development
tents such as occur.; in hemorrhagic follicles or they may of accessory COrpom lutea can be expected. large ''CS-
represent the onset of luteinization. At the time when ides which contained I10ccular echoes were found on
the follicu lar contents stans to show this echogenitilY the OV"J.ries of martS. 11lc lumina of these vcsicles then
the mure's bchavioml estrus usually ends. filled up with tissue that showed the chamcteri.~tic sano-
Arter the scattered inner echoes first become visible graphic features of corporn lutea. 11 could thus be as-
inside an anovulatory luteinizing follicle the narrow, sumed that these st ructures were. in fact. accessory
hypcrcchoic W'JII will progressively become wider and corpora lutea.

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34 U/lfasollographY ;1/ the mare

FIg. 1.35: Anovulatory rollicular hemlltoma in a marc. Within Flg. 1.J6: Ovarian hcmatom;J in a mll.rc. The hcm;Jtoma hlld IJ
the rolliculll.r lume n the st1O\\)' echogenicity ruuscd by hemor- dilJrnete r o r 2{) em and weighed 3.8 kg..
rhage i<; ..."Viden!.

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Follicular and ol'Qrian hematomru 35

1.2.4 Follicular and ovarian hematomas of rcneCiions that typically develops in the lumen of a
lutcinizing, anoorolatory follicle fails to dcvdop in this
In addition to the luteinizing, anovulalory follicles type of anovulatory follicle. In most follicular hema-
described above, there are also anovulatory follicles tomas the initially hypocchoic lumen will only develop
which develop inlo hemorrhagic follicles o r follicular regularly 5Callered noccular rencclions at II Illter stage.
hematomas (SoUIRES cl al. 1988. LEIDL and KAliN These can become more prominent as time passes.
1989). In the case of the anovulatory. hemorrhagic fol- Only rnrely will a few echoic lines become evident inside
licles the hemorrhage lakes place by diapedesis into the the follicular lumen. They are interpreted as being
follicular lumen. In Ihis type of anovullliory follicle no fibrin strands inside the hematoma as the Illner is
ultrasonically apparent luteinization occur.; in the becoming more organized.
follicular wall. When only the follicle fills with blood it is The diameters of anovulatory follicles which develop
referred 10 as II hemorrbagK:: follicle or II follicular into follicular hematomas are OCtOasionally only a little
hematoma. Where the surrounding ovarian tissue is larger than those of mature preovulatory follicles. Folli-
largely atrophic and the hematoma encompasses vir- cular hematomas sometimes expand considembly even
tually the entire ovary it is called II ovarian hematoma. after the end of estrus.
UltrolSOnically, follicular hematomas do not show a In rare cases ovarian hematomas with n diameter
widening. hyperechoic edge indicative of progress.r.'C lu- of 20 em and more and II ....-cight of scveml kilogmms
teinization (Fig. 1.35). Instead, the wall of these anovu- are encountered (Fig. 1.36). On ultrasound such hema·
latory vcsicJc remains hyperechoic and thin and appears lomas can appear ali CYSlic structures with evenly
to remain unchanged for a long period of time. even scattered sOQY.'·]jke echoes in their lumina.
beyond the end of a particular estrous period. The mesh

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36 Ultrasollography jll the marc

Hg. 1.37: Granulosa cell tumor in a marc. The tumo r consists Iolg. 1.38: Sectioned ovary with the gra nu lo!.a ccll tumor from
o f nume rous cystic structures. Fig. 1.37 arter O\Iaricctomy of the marc.

fig. 1.39: Homogenoously echoic gra nu losa cell tumor. Nar- Fig. 1.40: Sectioned ovarywilh granulosa cell tumor from Fig.
row echo shadows originatc from small foci of mineralization 1.39. The cut surface has a solid. waxy appearance.
in the IUmor tissue. Ultr.lsooogra m takcn in a waterbath.

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(Jl'tJriOI/ Illmor.r and C}'l'LS 37

1.2.5 Ovarian tumors and cysts the tumor consists of numerous small, lightly JXlekcd
vesicles (Fig. 1.37 and 1.38). On cross sectional image
The ultrasonic images of ovarian neoplasms can vary of GC tumors the proportion taken up by vesicular
considerubly. Among the most commonly encounlered structures is mostly greater than that occupied by solid
grnnulosa cell tumors the predominant fonn i.o; charnc- tumor tissue.
terizcd by a multicystic partitioning of the tumor AP.1rt from the multicystie grnnulOS:I cell tumors
(WIIITE and AlLEN 1985, KAHN and LEtDL 1987 b. there arc also those that are virtually solid on cross
lElDL and KAliN 1989). More vesicular structures can section (Fig. 1.39 and 1.40). Their uhrJSOnog.rnms
usually be counted in such tumors than ....'Quld be expec- depict a relatively homogenous image free of hypo-
led in normal. intact ovaries. On a normal ovary 5 to 10 echoic vcsicles. In some tumors there were llreas of
follicles with a diameter of more than 10 mm each .....iIl hypcrcchogenicity which were interpreted as areas
physiologically be found during an estrous cycle (PIER- of mineralized tumor tissue, which produced sound
SON and GtN11 IER 1987). In cases of ultrasonically ex- shadows beyond these foci.
amined granulosa cell tumors and in excised spximens Ovarian tumors consisting of a single large vcsicle
many more cystic structures ,",,-etC found. In single OV"d- with moderately echoic contents have also been found.
ries 50 to 60 cystic structures .....cre identified. Their walls sho.....ed histopathologiC'dl ehanges consistent
The diameters of individual vesiclc.o; in granulosa cell with those seen in granulosa ccll tumors.
tumors vary from a few millimeters to several ccntime- The taking of aa:urate measurements of an {)\Iary is
ters. A normal ovary is charactcrized by the presence of an imp.)rtanl application of ultrasonography during the
many follicles of differing sizes in the same organ. It is examination of ovarilln neoplasms. Measurements of
rare to find more Ihan 2 10 3 follicles with a diameter of the ovary taken at regular lime intervals make it p0s-
30 to 50 mm on a normal ovary, the majority of visible sible to cakulate the ~1h rate of the tumor. and to
follicles ranging in size between 5 and 20 mm. The ul· confinn the diagnosis. In addition. koov.'icdge of the
trasonic images of granulosa ccll tumors usually differ ovary's exact size lIid in the decision whether the ovari·
from this pattern. Sometimes single. c:<tremely large ectomy should be performed by laparotomy or truns-
\'CSicies are seen within a tumor or the entire image of vaginally.

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38 Ultrasollography itl the lIIan!

. ig. 1.41 : Ovarian (.)'Stadenoma in a mare. The ultr,iSOllOgl1lm .". 1.42: 5t<:tioned O\'lIry wi th C)'S'adenoma from Fig. 1.41
depicts numerous small, cystic structures. after O\'lIriectomy of the marc.

t• . 1.43: Large O\'arian e)'SI in a mare. The ron lents of lhe .1g. 1.44: Sectioned O\'lIry from Fig. 1.43. The O'o-ari;m cyst
cyst were largely anechoic. Other cysts or follicles \\''CTC nOI measured approximately 12 em in diame ter.
prescnt. Ult rusonogrllJll taken in II W3terbath.

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(A'aria" tumo~ ami C)'SIS 39

Cystadenomas arc much less frequent ly encountered cross scctiolt... The ultrasonograms showed hardly any
ovarian neoplasms in the mare than granulosa cell tu- islands of ovarian parenchyma bet"""ecn the cystic struc-
mors. In the cystadenoma... examined ultrasonically thus tures. The diagnoses of macrocystic ovarian degenera·
fa r. the tumor tissue varied in echogenidty and con- tion were based on histopathological examinations of
tained numerous cystic structures (Fig. 1.41 and 1.42). the organ after ovariectomy.
The vesicles with hypocchoic content.. measured only a Ultimately, it can be stated that the ultrasonic ap-
few millimeters in diameter. peamncc of ovarian tumors and cysts can vary consider-
Ovarian cysts occur only very rarely in mares. The ul- ably. An accurate diagnosis of thc ovarian changes.
traS(mic image of macrocyslic ovarian degeneration fea- based on ultrasonography alonc. is not possiblc in cvery
tures a few. very large cyst ic structUTCS (LEIDL and case. In many inslanccs. however. ultrasonogmphy con-
KAl iN 1989). The cyst walls """eTC echoic and remarkab- tributes meaningfully to the establi.. hment of a correct
ly thin (Fig. 1.43 to 1.46). The cysts were polygonal in therapeutic conchl..ion.

Fig. 1.45: Macrocystic CMl rian degeneration in a marc. Mul· fig. 1.46: Mncroc),stic degeneration and atrophy of the func·
tiple. thin wa lled cysts wi th anechoic contents arc presc nt on tional ovarian tissue in the scctioned ovary from Fig. 1.45.
th e ovary.

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40 UltroSOllogropilY ill the mare

Fig. 1.47: Sugittal cross section th rough the uterine hom of a rig. 1.48: Cross SCdion through merine hom during CSt m~.
mare in diestrus. The hypocd1oil; peritoneal bord<::r (large ar· Due to the endometrial edema alte rnming areas of hypo·
ruw:s) and the trnnsition from myomet ri um to endome trium echoic and more echoic tissues can be seen. This muses the
(small :!1"I't)\\'S) can be seen. typical spol;e ...... hl'Cl appc:lr:mcc of the uteri ne ho m during
estrus. Arrt:M'S indicate the truns;tion from myo- to endo-
metrium.

Fig. 1.49: Prominent spol;e.whccl pattern of the uterus during "'\g. 1.50: Euensn.-c edema of the endometrial roJd~ during
~t rus. A I"I't)\\':S indic:lle the peritoneal border of the uterus. ~t rus. 1lie endometrial folds wi th their echoic base. hypo-
t'Choic edematous tXntrnl area and hypel'l'Choic surface bulge
inc o the uteri ne lume n (L) fi lled with secretions.

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UtenLS 41

1.3 Uterine structures in the mare distinction between areas of differing echogenicity can
bcobscrvcd in the tmnsversc view of the uterus of mnny
1.3.1 Non-pregnant uterus mares (Fig. 1.48 to 1.50).The ring like structure in the
area between endo- and myometrium which lies con-
A sagittal eros.... section of a physiologic, nonpregnant centrically oriented to the outer, peritoneal wall of the
utcrine hom is sonographically secn as round to oval uterus is now very prominent. From this zone hypo-
image (Fig. 1.47 to 1.49). The utcrine wall appears as a echoic stripes run towards the center of the lumen
gray structure of moderate cchogenicity. The peritoneal where they meet to fonn a star (spoke-wheel) pattern.
border of the uterus can be seen as a thin, hypocchoic Hypcrcchoic segments lie between these areas of low
line. ConcentriC'Jlly positioned to this linc, another line echogenicity. This pattern is caused by the endomctrial
can Ql)"1!sionally be identified in the middle of thc uter- folds which bulge towards the center of the uterine
ine wall (KAli N and I..cIOL 1985). This hypocehoic zone lumen and consist of an echoic base, the hypocchoic,
represents the transition from endometrium to myo- strongly edematous adluminal pan and the hypercchoic
metrium (Fig. 1.47 and 1.48). In the centcr of the utcrus luminal epithelium. This wagon wheel pattern of the
a small area of high cchogcnicity can sometimes be uterus is typical of estrus and can clearly be secn in
found. It is caused by reflections from the echoic surface about 50% of all estrous mares (GINTlIER and P IERSON
of opposing laycrs of the endometrium which lie in close 1984 c). It is associated with thc cstrogenisation during
apposition in the empty uterus and project as an echoic estrus and becomes appare nt 6 to 10 days before ovula-
spot when seen in ~ section or as anechoic line when tion (HAYES el al. 1985). The pattern is best developed
viewed longitudinally (Fig 1.6). about I to 4 days before ovulation and thcn graduatty
The structure of the uterine wall is homogenous dur- and progressively \\'Cakcns until it disappears 2 to 6 days
ing anestrus and diestrus (Fig. 1.47). A distinct layering after ovulation.
cannot be recognizcd. Around the time of estrus a clear

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42 UltrasQnography in 'he mare

FIg. 1.51: Uterus (arJ'O\.\'S) of a mare immL"CIiately after mat· rag. 1.52: Uterus on Day9 of pregnancy (DayD - Dayof ovu-
ing. The uterine lumen contains hypoechoic scoren whidl is lation). The anechoic. embryonic\1CSicJe has a diameter of 4 to
speckled with floccular rcncctions. 5 mm and lies centrally in the hom (al'TOY>'S).

FiR. 1.53: Conceptus on Day I I of pregnancy. The anechoic Ag. 1.54: Conceptus on D:IY 14 of pregnancy. The spherical
embryonic vcsicle shows the typical specular refkt1ions where embryonic vesicle lies ccnlmlly in the ute rine hom and meas-
the sound Yo'll\1CS impact vcnicaJlyonto its front and bock walls. ures 15 mm in diame ter.
Its diameter measures 9 mm.

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Pregnancy 43

Larger fluid 3ccumula(ions of a physiological origin few days, between Days 9 and 13 of pregnancy (Day 0 -
will not be found in the nonpregnant uterus. Sono- Day of ovulation or last day of service). When using
graphically evident secretions in the lumen of the dies. high resolution ultrnsonography \\; Ih a frequency of 5
lrous uterus can be seen as a indieation of endometritis MHz, 3 to 5 mm large conceptuses can be detected as
(ADAMS et al. \987, SQUIRES et al. 1988). During estrus early as on Day 9 of gestation. On Day) 0 the blastocyst
small amounts of free fluid may be seen as physiologie, measures 4 to 7 mm and will be detectable in as many as
but larger o nes as pathologic (Fig. 1.50). Immediately about 70% of the mares (GINTHER ) 986). On the Day
after mating, the ejaculate can be secn in the uterine lu- 11 it reaches 6 to 9 mm and will be visiblc in nearly all
men (Gl!'o'11IER and PIERSON 1984 e). Mares whose uter- mares (Fig. 1.53 and 1.55). Around Day 12 the concep-
ine lumina were initially closed, show fluid accumula- tus has a diameter of 10 to 12 mm and can now be de-
tions containing scattered echoes after service (Fig. tccted evcn with scanncrs of lesser resolution using 3 10
1.51). 3.5 MHz frequcncies (GINlliER 1983 b).
The uterine cervix is depicted relatively poorly. Its ul·
trasonic image is more echoic during diestrus and preg-
nancy and is therefore easier to recognize than in estrus. 1.3.2.2 Day 14 to 20 of pregnancy
By Day 14 the embryonic vc...icle has a diameter of
14 to 19 mm (Fig. 1.54 and 1.55). The embryonic vesicle
1.3.2 Pregnant uterus is now large enough to make accurate and reliable posi-
1.3.2.1 Day 9 to 13 of pregnancy tive as well as negative diagnoses under field condition
of general veterinary practice. provided 5 MHz ultra-
The young conceptus fi rst becomes visible when it sonography is used (Kiihn and Lcidl t 984). Using ultra-
forms a fluid filled vesicle, large enough to be recog- sound of lower frequcncy, this date may be postponed
nized as a round, anechoic sphere on the ultrasound by a few days (Q-!EVAUER and PAI.MER 1982). The
monitor (Fig. 1.52). Depending upon the quality of the shape of the embryonic vesicle is spherical and the
sc.1nner, this is first possible, with a variation of only a embryo proper is not yel visible.

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44 Ultmsonography ill tire marl!

60 60
.,. ,
,. .. - -
-,
,.
" .j. , •• ,.

.." , .,
-,. ,- " ~-.

.-.' ..
-,- - .-,--
J6

... -- '.-- .. -~.

20

16
-,- .. ". , -,
20

16
,
12 12
,.~-;" -,-., ~"i-.'"

4
.'. •
,
o o
10 15 W n ~ ]5 ~ 45 ~
Days of pregnancy
Fig. 1.55: Groo1h o f the dia meter of equine embl)'Onic \.cs-
iclcs during emly pregnancy (ad3pted from GIN'IlIl;K 1986).

"-'g. 1.56: Pregnancy on Day 16. The embf)'Onic \"CSicic h:1S an fig, 1.57: I'regna ncy on Day 18. 1bc embl)'Onic \"CSiclc. lo-
ovoid shape. measuring 26 x 2fl mm. '11e largcst diameter is co.ned in the ute rine hom (U I"f"O\Io'S ), is pear shaped.
marked by the 2 Cf'O!;Ij(:s below the \'CSic\c.

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PregnallCY 45

The embryonic \'csicle grows at an a\'emgc rate of 3 trahlleml horn. Increases in Ulerine tone and size of the
to 4 mm per day during the second week of gcstation conceptus seem to be the ColUse for the cessation of con-
until the beginning of the third week to reach a diame- ceptus mobility. The preferred site of implantation lies
ter of20 to 25 mm by Day 16 (Fig. 1.55). After this date just next to the bifurcation in one of the uterine horns.
the growth curve nallens considembly. The diameter of In the horse the early conceptus has a strict ly spheri-
the conceptus appears to increase o nly marginally and cal shape until Day 15 of gestation. thereafter first be-
seems 10 rest on a plateau between the 17th and 25th coming ovoid until d"y 17 <Ind. between Days 18 lind
days of pregnancy (PAU,1ER and DRIANCOURT 1980. 21 it is usually pear shaped, after which it assumes an
YAWN et a!. 1982, GtNTIlER 1983 b). Breed related irregular shape (Fig. 1.56 to 1.59).
differences in the size of embryonic vesicles are negli- From the time the conceptus is first detected until
gible during the first three weeks of pregnancy. Even Day 18 the uterine ....-all is 10 to 15 mm thick. It becomes
the growth curvcs of pony and large horse breed thinnerovc rthe nexi few weeks and ranges from 5 to iO
embryos are vinually identical (Gtl'm-lER 1986). mm. Initially, the uterine wall is of unifo rn} thickness
A remarkable phenomenon in the horse is its em- around the entire conceptus (Fig. 1.52 and 1.54); from
bryonic mobility which can be observed by ultrasono- Day 18 to 20 on its thickness decreases. particularly vcn-
graphy from the time the conceptus first becomes visi- trollly to the conceptus (Fig. 1.58).
ble until Day 17 of gcstation (GtNl1tER 1983 a). The There nre numerous criteria which can be used to
conceptus movcs from one hom to the other. and differentiate the enrly embryonic vcsicle fronl patho-
through the uterine body seveml times every day and logicnl conditions such as endomel rinl cysts. the secre-
may be found in different positions within thc uterus tions in cases of endometritis or embryonic death. At
during successive ex'lminations (GI/\'11IER 1984a). This Ihis sl:lge the intact conceptus is a round spheric.'l1 vcs·
movement of the embryo can sometimes even be 0b- icle clearly visible and contrasted :lgainslthe echoic utero
served if a mare is scanned continuously for a number of ine wall. There :lTC no renections inside the vesicle so
minutes. The mobility is particularly strong from Day II that its nuid coments appear bl..ck. I f the probe is
to 14 and comes 10 a halt on Days 15 to 17. It has been swept across the vesicle the increasing and decreasing
shown through frequent examinations in 5 minute inter- diameter reveals the spherical shape of the conceptus.
vals that the embryo moved from one hom to the other At the front and back sections of the conceptus. whcre
or into the uterine body an avemge of 7 times within 2 the sound waves imp..'lct \'Cr1ically onto the wall. a shor1
hours during the period of maximal embryonic mobility hypcrechoic line c:ln be seen (a~ EVAUER :lnd PAU,IER
between Days II and 14 (Leml and GIl\'11 IER 1984). 1982). These bright lines are the result of the specul:lr
From Days 9 to 11 the embryo was found in the uterine rcnections of the ultrasound wavcs from the wolll of
body in 60 % of the cases, from Day t 2 to 14 in 30 % of the tense e mbryonic vesicle and should nOi be mis-
cases and thereafter only rarely. The positional changes interpreted as the embryonic disc (Fig. 1.53).
of the conceptus appear to be caused by contractions of In veterinary practice there exists concern about the
the uterine wall and can be controlled by the conceptus optimal time for early sonographic pregnancy detec-
iL'iClf (GIN11lER 1984 b. urnl and GIN11IER 1985). The tion. For several reasons the time from Days 15 to 18
careful sonographie examination of the corpus uteri cm be considered most appropriate. At this stage it is
during this stage of early pregnancy is of particular no longer difficult to demonstrate the early embryonic
diagnostic importance. Duc to its intense mobility the vesicle. Not only lire twin pregnllllcie!l easy to rerognizc
conceptus frequently lies in the uterine body. If only the at this time period but it is quite ftwomble for a timely
uterine horns are seanned by ultrdSOund the further intervemion where indic lled. In C'dSC of detection of
caudally positioned conceptus may remain undetected non-pregnancy the ultra. . ound examination C'oln be u.'iCd
inside the uterine body. This is one of the most common to assess follicular development. becau."oC the following
reasons for not detecting or overlooking a conceptus o r estrus should be imminem.
twin pregnancy. The intra-uterine positional changes of Once ,Ill early pregnancy has been diagnosed in a
the equine conceptus can lead to, among other things, mare during the first few ....eeks of gcstation. it is useful
implantation not only in the hom ipsilateral to the ovu- to reexamine the mare at about Day 30 of prcgnnncy so
lating ovary. but. in about half the cases. in the con- that .1 possible e:lrly embryonic death can be detected.

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46 Ultmsollogmpily ill the mare

nl. 1.58: Pregnancy on Day 20. The shape of the emb r)Unic "•. 1.59; Pregnancy on Day 21. The embl)unic \'CSicle is ir-
vesicle is triangular. The embryo (E) can be seen at the floor regular in shape. The embl)'O (E) lies on the floor of the
of the vcsicle. Below the vesicle the uterine ....-all is rclati\'ely vcsicle .
thin.

"lg. 1.60; Ultrasound image of the rubber balloon of a bal·


Iooned catheter wi th in the uterus. In order to ~mulat e an
embl)tmic "cside the balloon ..... a.~ filled with 20 ml .....me r and
then de picted by ultrn.o;onogrnphy. The catheter (arrow) is
shown in ~ SI,.'CIion at the ccnterof the balloon.

Ayrs OZ C 10
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Pregnanc), 47

By this time the majority of embl)'Onic deaths will have the uterus is suitable for this purpose. Once the tip of
taken place or will be in progress (GIl'ffHER 1985. the catheter is positioned inside a uterine hom the in-
WOODS et al. 1985). The successful induction of an- sumation channel is used to fill thc cuff with liquid
othe r estrus is still poss.ible and valuable time will not ix: making sure not to include any air in the nuid. In this
wasted. Since e mbryonic deaths can also occur after manner the injection of 5 o r 15 ml water into the cuff
Day 30 of gestation another examination is recom- will result in a balloon diamcter of 20 or 30 mm. These
mended bcty,'Ccn Days 50 and 60 so that all embryonic diamcters would be equivalent to the sizes of an em-
losses can be detectcd. bl)'Onic vesicle on Days 15 or Days 25 to 30. For train-
In the conten of carly pregnancy diagnoses. a train- ing purposes a balloon introd uced in this manncr can
ing method for the detection of early pregnancies by now be sought using ultrasonography and then de picted
ultrasonography should be mentioned. In the absence on thc monitor. Sco.·cral features of the image of such a
of a suitable training mare, a water fil led rubber balloon balloon are similar to those of an early conceptus. After
can be introd uced into the uterus to simulate an early the training examination thc balloon can be emptied
pregnancy (Fig. 1.60). A ballooned cathete r (e.g. Foley and removed without problcms.
cathetcr) which is introduced through the cervix into

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48 Ultrasonogmphy ill the mare

Ectoderm
Endoderm Yolk sac
Mesodenn Allantoic sac
rig. 1.61 : Schematic presentation of a Day 30 embl)'Onic Fig. 1.62: Pregnancy on Day 27. The Masccnt" of the embl)'O
\-esiclc in the norse. Due to shrinkage of the yolk sac and the (arrow) has begun. The ventrally positioned 311:mtOO starts 10
fi lling of the allantois the cmbl)'O asce nds from the floo r and filJ up.
rises within the vesicle (adaptcd from G I1'o"JlIER (986).

Fig. 1.63: Pregnuney on Day 29. The embryo is suspended in FIg. 1.64: Pregnancy on Day 30. 1be embl)'O is suspended in
the center of the embl)'Onic \1:sicle. The appositioned memo the upper ponion of the vesicle.
branes of the yolk sac (Y) and the allantoic !Ole (A) form a
hyperechoic structure which extends from thcembryo lowartls
the lateral walls of the \'C:Sklc (sec also Fig. 1.62 to 1.67).

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PregllallCY 49

1.3.2.3 Day 21 to 40 of pregnancy by Day 30 in the t'enter (Fig. 1.63) and by Day 33 in the
top third of the vesicle (Fig. 1.64 and 1.65).
On about Day 21 the embryo is deu.:ctable for the On Day 25 the emhl)'O is ilbout 5 mm long (GIN-
first time ncar the floor of thc vesicle (G INlli ER 1983 b, THER 1986). It gf'OVllS by about I mm per day to reilch 12
KAHN and lElol. 1984). It is initially visible as a hyper- mm by Day 30. 17 mm by Day 35 and 22 mm by about
cchoic spot on thc floor of the embr),onic vcsicle and Day 40.
not yet scpar,lIcd from the endomctrium (Fig. 1.58 and The embl)'OS hcart beat can be detcc1ed around day
1.59). 26 which is only a few days after the embryo can be first
From Day 21 to 40 the embl)"O follCM'S a character- detected. The hellrt bcilt is illl important criterion for
istic ascent within itsvcsicle (VAWN et al. 1982). Ven· the assessment of embl)'Onic viability :lIld for the exclu-
tmlto the embr),o the allantois starts to fill up, lirting the sion of a JXlthological pregnancy.
e mbtyO (Fig. 1.61 to 1.(6). While the yolk sac above the After the suspended growth period of the conceptus
embtyO initially occupied the bulk of the early concep- from Day 19 until Day 25 there is a renewed growth
tu... it now shrinks over the next few days. The mlio be· (Fig. 1.55). The gTCMth r.Jte until Day 50 of gestation is
tween the sizes of the t\\'O embryonic structures gradu· i1bout 2 mm per day. From the fourth week of gestiltion
ally moves in favor of the allantois until the yolk SOIChas a difference in the growth rate bct\\'ccn fetuses of differ-
virtually disappeared by Day 40. The embryo appears to ent breeds becomes evidcnt ; hence the diameter of the
Ix: suspended by the hypcrcchoic membrane formed by cmbl)'Onic "cside of heavy dmught horses betwcen
allantois and yolk sac and floats inside the anechoic em- Days 20 and 40 of gestation will be I to 4 mm larger
bryonic fluid . The majority of embryos commence their than that observed in lighter horse breeds (OmvAu ER
ascent between Days 22 and 25. On Day 27 they are still and PAU,tER 1982).
suspended in the bottom third of the vesicle (Fig 1.62),

I by Dr.Stator & Saraajka


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50 UltTOSOllogmplJy in the "'lin!

Fig. 1.65: PrcgmHK)' on Day 32. The embryo floa ts in the up- rig. 1.66: I'regnancy on Day 35. The cmbryo is suspended
per third of the embryonic \·csicle. The )Ulk sac (Y) has reo vcryhigh in the cmbl)'Onic \'CSiclc. Thc )'Olk sac has alman dis-
ceded considcrnbly. The allantoic sac (A) is c~nding. appeared.

fig. 1.67: Pregnancy on lJ:ly 40. The cmbl)'O (3I"l"00') de- tlg. 1.68: Pregnancy on Day 37. The embl)'Onic vesicle is dis-
scends bOlck tow:mls thc floor of the vesiclc while it hangs oriented. The allan loic il.1C (A) lies at the top and thc )Ulk sac
from thc umbilical cord which still shows remnants of the yolk (Y) al the bottom. In Ihis mare the - ascc nt- of Ihe embryo
~. within its \'e5ick: ",.'as from the top to the bottom.

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Pregnancy 5J

1.3.2.4 Day 41 to 60 of pregnancy which ensures that the conceptus is oriented with the
embryonic disc al its vcnl.r.:al aspect at the time of ftX.1 -
Around Day 40 the embryo reaehes it<; highest posi- tion between Days 16 a nd 20. This also leads to the em-
tion within the embryonic vesicle (Fig. 1.66 and 1.67). bl)'o rising from ventral to dorsal during its ascent be-
From here it gradually sinks, suspended by its umbilical tween Days 20 and 40 and to the attachment of the
cord. back down to the floor of the vesicle (KAliN and umbilicus to the dors.11 aspect of the allantochorion.
l.J:JDL 1984). After this time movements of the fetus can This procc....<; sometimes appears to be dist urbed in twin
be observed frequently (Al.l.EN and GODDARD 1984). pregnancies when the two vcsicles interfere "-i th one
The umbilical cord normally attaches to the dorsal another's orientation "-i thin the uterus.
pole of the allantochorion. Very rarely it attaches lat- The fetus has a crown rump length of25 mm on Day
erally or ventrally. Cases have been observed where the 45 of gestation (Fig. 1.69) and grows to a length of 40
yolk sac was positioned ventrally and the allantois dor- mm by Day 60. The placental vesicle reaches a diameter
saUy to the embryo leading to an embryonic migration of 6 em bclY..cen Days 45 and 50. Subsequently it cx-
from top to bottom within the vesicle (Fig. 1.68). It is as- ceeds the scanning width of the 5 MHz scanner and can
sumed that this kind of disorientation of the embryo is a onlybc depicted in sections (Fig. 1.70). From Day 50 [0
sequel to an eurlicr twin conception (GtNTIIER 1984c). 60 a penetration depth of 10 em is also inadequate [0
In singleton pregnancies the re seems to be a mechanism show the vesicle in its entirety.

FIg. 1.69: Pregnancy on O:ly 46. 1bc fcms lies on its buek on fl&. 1.70: Pregnaocy on Day 54. 1be dia.meter of the COIK'CP-
the floor of the \·csidc. Its crown rump length measu res 33 [US exceeds the scanning width of the ult rasound probe. The
mm.1bc head with the eyes (E) lies to lhe left. head (H) of the fetus lies to the left. The umbilical cord runs
loward~ 3 o'clock out of the picture.

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52 U1/rflsollogrophy ill /he mare

r ig. 1.71: T .... in prcgn:mcyon Day 13. The two \'csiclcs are bi- t-lg. 1,72: Twin prcgnan(.)' on Day ] 6. The two \'csidcs are uni-
[aternl, one in each hom (arro....s). lateral nnd close tl)h'C the r.

~ 1.73: Twin pregnancy on Day ]4. Only one embryonic f1g. 1.74: Single pregnancy on Day 22. Due to the un ravorable
\"CSide seems to be visible. In relation to the Inst service date positioni ng or the ultrasou nd probe the common membrane
this vesicle is 100 large. 11lc opposing w,dls or the two vesiclcs or allantois :lOd yolk ~c (alTO'W) is depicted without the em-
are hidde n (rom view. bryo. A misinterpretation as a twin pregnant)' is possible.

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Twill pregllallc), 53

1.3.2.5 Twin pregnancy If the fi rst examination is perfo nned after Day 20 the
ascent of the embryo with the development of its char·
An imponant indication for the use of ultmsonogm· acteristic septum across the middle of the vesicle will
phy is the timely diagnosis of a twin pregnancy. The fre · have already stan ed. This membrane whieh is fonned
quency with which twin pregnancies are diagnosed de· jointly by allantois and yolk sac can lead to the mis-
pends o n the time of the eltamination as well as the interpretation of a singleton embryo a... a twin (Fig.
breed of the horse involved. It has been reponed that 1.74). Equally, a twin with closely appositioned memo
the incidence of twin pregnancies diagnosed between branes of the two vesicles which arc misinterpreted as
Days 13 and 21 is 15 % in pregnant Thoroughbred being the allantois yolk sac membrane of a singlelOn is
mares and o nly 6 % in pregnant Standardbred mares possible. The hypcrcchoic line fonned by the apposition
(BoWMAN 1986). If the examination is performed later of t....-o chorionic membranes usually runs stmight and in
and Wannblocx:ls and dmught ho rses are included. this a venical direction, whereas the allantois yolk sac mcm·
percentage may drop to I to 3 % (OIEVAUER and brdne commonly lies ho rizontally (SIMPSON et al. 1982).
PAU,1ER 1982). The detectio n of twins during the early A ' 'Cry significant source of error is the examiner being
stage of gestation requires a very carefully executed satisfied with the detectio n of one embryonic vesicle
ullrasonographic examination of the uterus. The diag· and neglects to examine the remaining sections of the
nosis is possible with relative ease betv.'Cen Days 12 and uterus fo r another vesicle. During the phase of em·
16 (Fig. 1.71).Bilaterally positioned twin conceptuses bryonic mobility until Day 16 of gestalion the embryos
are not difflClllI to recognize, provided the examination freq uently lie in the uterine body whe re they are ea ..ily
is carried out conscientiously (MERKT el al. 1983). overlooked. At the time when a singleton embryo i... de·
Difficulties are encountered in cases of ipsilateral twin tected on Day 14 or IS. another embryo from a second.
pregnancies where both conceptusc." lie close together asynchronous ovulation days later may still be too small
in the same hom (Fig. 1.72 to 1.74). to be found by ultrasonography. Sincc asynchronous
Many factors C'dn contribute to the fai lure of recog· double ovulation... with a time interval of 48 to 96 hou ~
nizing a twin pregnancy. When two embryonic vesicles between ovulations can still lead to the conception of a
lie close together the positioning of the scanning probe twin pregnancy, the younger of the two embT)'Onic ves-
may make it impossible to see the thin. echoic memo icles will be 2 to 4 days less advanced than the older and
brane fonned by the two closely appositioned SCts of thereby have a diameter smaller than can be detected by
vesicle walls (Fig. 1.73). The presence of twins should ultrasound (Gtl"lrHER 1986). Endometrial cysts may
be suspected when an embryonic vesicle is too large for also lead to a faulty diagnosis of a twin pregnancy
its age as detennined by the last service date ofthc mare. (SIMPSON el al. 1982).

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54 Ultrasollography in the m(lre

Fils:. 1.75: Twin pregnanqo on Day 28. Don.ally. a duster of ,,,. 1.76: Twin prcgnanqo on Day 37. The two embryonic
multiple endometrial cysts (C) can be secn. Thcy e-.m generale \"CSidcs nppear to be fused. '-""'0 embl)'OS arc visible.
difflClJhics in diagnosing a I",,; n pregnanqo. To enMire an ac-
curate diagnosis the two embl)'OS (E) ..... ith the beating heart in
each should be dcpicloo.

fig. 1.77: T""1n prcgnanqo on Day 15. The vcsicle on lhe left
has the appropriate size in relation to the service dale. where·
as the one on the right is too small.

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Twin prt"8,wllcy 55

There arc rn<lrcs with rnuhiple endometrial cystS lead to abortion during the advanced stages of preg-
which c.1n make the search and detection of twin ves· nancy.
icles in the uterus particularly difficult (Fig. 1.75). Oc· The following approach is reoommended for vet·
casionally it is difficult to find the membrane that di· erinary practice: Where twins of clearly differing sizes
vides the two vesicles of a twin pregnancy (Fig. 1.76). are diagnosed until Day 16 of gcstation, the possibility
Where uncertainty e~tS the final decision should be of a spontaneous resorption should be considered. In-
postponed until the time when the detection of lWO tervention may be postponed until 2 to 3 days later
hean beats can be expected. when it is evident from the follow-up examination that
The individual embryonic vesicles of a no rmal twin both embryos ha\'e continued to develop since the pre-
pregnancy often show the same growth rate as that seen vious examination, Where twins are found before Day
in singleton pregnancies (GtNll-lER 1984 b. PtPERS et 31. 16 and both vcsicles appear to be intact it is useful to
1984). attempt the reduction of the pregnancy to a singleton
In spite of that the sizes of individual vesicles in cases pregnancy by manually crushing of either of the t....,o ves-
of twin pregnancies can differ (Fig. 1.77). This may in· iclcs. Since both vesicles are still mobile at this stage,
dicate that the smaller member of a twin is retarded and repeated examinations can be performed until the two
is in the proces.<; of undergoing an embryonic death. vesicles are found to be far enough apart so that the one
However, in cases where twin vesicles of unequal size can be crushed without harming the second o ne. If a
are detected the categorical oonclusion that the smaller bilaterally rued twin pregnancy is first detl'C\ed after
embryo must be dying. will often prove wrong. Asyn- Day 16 an intervention is indicated, because it is likely
chronous double ovulations with an interval of 48 to 96 that both embryos will persist. Since a sponulOcous
hours between ovulations can lead to twin pregnancies. resorption is more likely in unilaterally rlXed twins after
The two oonceptuses will show differences in their Day 16 an intervention can be poslponed for some
stages of development, but can both continue to persist time.
and grow into the fetal stage of pregnancy. Once a twin pregnancy has been reduced by crushing
In unilmeralty rlXed adjacent twins an embl)'Onie of one vesicle the successful elimination of the one and
mortality is likely between Days 17 and 29 (GtNT1~ER the further development of the other vesicle should be
1984 c). Prior to this, during the phase of mobility, re· monitored ultrasonically. Where an embryo has been
sorptions are r.lre and after this until Day 45 onlY, k'W eliminated by crushing it before Day 20 the survival
mortalitics will occur. The resorption of one member of chance for the second conceptus is good, but in later
a twin is morc likely than that of both. Bilaterally rued cases one must expect the second embl)'O 10 die
twins oontinue [0 develop in the majority of cases and (BoWMAN 1986).

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56 Ultrasonography ill the mare

Hg. 1.78: Twin pregnancy on D'JY 39. 1be t.....o cmbryonic Fig. 1.79: Twin pregnancy on Day 129. 111(: trunks of 1\\'0 fe-
\'i.!Sick:s lie next 10 each other and lire ... isible on the same tuses lie next to each other. 'The L"Choes produced by the ~
ul trasonogram. 5Cdions of the nbs (a rrows) of both fetuses am be seen.

10cm

Fig. 1.80: Instrument lllion for tmm;vagi nal sonogmphy. including the au tomated punctun: device (LAtl(Jt'£CT. GOlllngen. Ger-
many). l)(.'Vlces for adjustme nt and triggcring oft ne automated punctun: an: .'l itU3tL-d on tne left a~ of the handle. The scan·
ning head (arrow) of the vaginal probe (SIEMDo~. Erlange n. Gc nnany) is pushed up to the cranial V'.J.ginal wall. J\OOo.e the tube
for the probe is the ch:mnel with the puncture needle.

Av~ SkO z. ~ 10 ad c
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Tro/lSWlgil/al sol/agraphic pUllcture 57

From Day 40 even in unilater.ll twin pregnancies the automated puncture device (Fig. 1.80). The handle of
two fetuses may be so far apart that it may be difficult to the vaginal sector probe is fIXed within the tip of the bar-
capture both on a single ultrasound image (Fig. 1.78). rel. A spring mechanism is used to drive the puncturing
In advanced gcstation (2nd and 3rd trimesters) it is needle and an adjusting screw is used to set the depth to
difftCUlt to diagnose twin pregnancies by tr.lnsrcctal ul- which the needle can he shot beyond the tip of the
tr.lsonogr.lphy. Sometimes it is possible to see two fe- probe. The depth and direction of the puncture can be
tuses (Fig. 1.79). Where this is possible the existence of determined aiming with two puncture guide lines on the
a twin pregnancy can be confirmed. Should only one ultrasound monitor (Fig. 1.82). The total length of the
fetus be detectable making a diagnosis of a confirmed instrument is nbout 80 COl.
singleton should be approached with caution. The punctures arc performed after the vestibulum
and vagina are prepared aseptically and the mare is se-
dated. For the sake of sterility the instrumentation is
1.3.2.6 Transvaginal sonographic puncture covered in a sterile plastic sleevc. The tube of the in-
of the conceptus strument with the attached puncturing device is intro-
duced into the vagina in the same manner as a tubular
Since the manual reduction of a twin pregnancy is speculum. It is pushed against the anterior vaginal wall
usually not successful after Day 20 to 25, the possibility and one hand introduced into the rectum to hold the
of eliminating one conceptus by controlled puncture uterus caudally and fIX it against the ultrasound probe.
was considered. It appeared promising to puncture one Once the image of the conceptus is aligned with the
conceptus undcr visual control of a vaginally introduced puncture direction of the needle the trigger mechanism
ultrasound probe. is activated. The plastic sleeve is penetr.lted by the
For this purpose a pistol-like instrument was de- puncture needle when the trigger is pulled. It is possible
signed. The barrel of the instrument accommodates the to aspirate fetal fluid through the needle.
ultrasound probe and on the handle is a trigger for the

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58 UltrosollogmfJhy ill the lIIure

rIG. 1.8 1: Tral1SVllginal puncture of an embl),tmic vcsicle on I-'Ig. 1.82: T rJnsv.tginal puncture of a ronttptus on Day 50 uf
Day 29 of gestation. The purn.1ure necdle (arrow) has pene· gestation. The puncture nt'Cdle lit:s between the two guide
truled abou t 2 em into Ihe vesicle. Within the conceptus the li ncs. A trnt~'Cr5C section through Ihe feluscan be secn in the
dctaehing embr)'Onic mcmbrant'5 can be '\Cen. The ~"O/lco:plUS upper left of the \'C'iick. TIIC oorn..'cptUl> wu.~ subsequently
.....as subsequently rc..-.orbed. resorbed.

l'lg. 1.83: Trnnsvaginal puncture of a conceptuS on Day Sol of


gl'5tation. The puncture needle ru ns Oct.... een the two guide
lintos to a depth of 3 em. Thc prcgnarn;y continued to dC\oclop
after the puncture.

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Trorm'ogillol sollogrophic pWlcfllre 59

Experiences with tmnsvaginal punctures of concep- and 50 the conceptus died after the puncture, One con-
tuses in the hOf5C are still limited, In the punctures per- ceptus which had been punctured on Day 54. and from
formed thus far one could usually observe a change in which 7 ml allantoic fluid had been collected, continued
the typical features of the embryo or fetus immediately to develop (Fig, 1,83), This pregnancy W.JS purposefully
following penetmtkm of the vesicle by the puncture interrupted on Day 75 by the collection of a large vol-
needle (Fig, 1.81 and 1.82). Within the vesicle echoes ume of fetal fluid.
reminiscent of floating parts of membranes became evi- Only one conceptus was punctured in each of two
dent. These were assumed to have been freed placental twin pregnancies on Days 29 and 44 of gestation. re-
membmncs. Immediately after the puncture the em- spectively. The remaining member of the twin pregnan-
bryo changed its position. coming to rest on the floor of cy was intended to pcl1iist and develop as a singleton
the vesicle, pregnancy. In both cases, however. both conceptuses
To date six punctures on singleton pregnancies have died. In all cases the death of the conceptus was ap-
been performed between Days 19 and 75 with the aim parent within days of the puncture. Usually, a heart
of aspirating small quantities of placental fluid, In 4 beat could oot be detected by ultrasonography on the
pregnancies which were perfonned between Days 19 day following the puncture.

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60 UltmsOllogm/JI,)' ill lite morc

Fig. 1.84: Tmnsrcctal image of the eye :md braincase of a fe- t"!g. 1.85: Longillldinal section through the neck of a fetus on
tus on Day 151 o f gestation. In the anterior aspt.-ct of the eye Day 154 of preg.nancy. 11H: arches and lxxIies of three verte·
the caudal wall of the lens (arrows) is depit.1ed. brae delineate the spinal e:anal (S). Behind them shadow ani-
faCl$ c.~tend into the depth of the imag.e.

'"
,.,
,.,
0E- ,.,
c

- '"
OJ ,.38

" ""
~
Y _ 189.3 - 0.44:l
r •
p s
0.$9
0.01
'" 'co
'",
.,0
., . '''' UO 180 110
Days of pregnancy
:uo no )00 ):10

rig. 1.86: Horizontal section through the thorax of a fetus on Fag. 1.87: The heart rate of equine fe tuses (Thoroughbred and
Day 134 of gestation. The echoes fomlCd by the cros..~ sections Standl1rdbn.:d) during pregnaocy (adapted from KAII:-/ and
through Ihe ribs of bolh ha ...·es of the chest run in (Wo lines to- LEIOI. 198711).
wards each other. Between Ihe 11,1,'0 lines three e:ardiac cham-
bers (1. 2. 3) are visible.

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Equine/ellis 61

1.3.3 Ultrasonography of the equine fetus few millimeters thick (Fig. 1.84). The oval o utline of the
brdin cavity can be depicted until about the 8th month
After Day 60 of pregnancy, significance of transree· of gestation. After that the OAAification of the bones of
tal ultrasonography for merely diagnosing pregnancies the cranium ha,<; progre<:scd so fa r that only the bony
in the ho ~ decreases. At this stage the emphasis of the parts in proximity of the tr.msducer can be imaged.
value of the ultrasound examination shifts towards fe tal The most apparent structure in the neck is the cervi-
diagnostics. Through sonographic observation of the fe- cal spine (Fig. 1.85). The ossificiltion centers of the ver·
tus in utero, the depiction of its IxxIy parts and organs tebral bodies "nd arches produce disc like echoes. Due
as well as taking fetal measurements - the so called feto- to the absorption of the sound wavcs, ultrasonic shad-
metry -, fetal development can be monitored and a... ows ilre seen beyond the vertebrae.
sesscd (KAHN and LEIDL 1987 a). Important conclu- When the probe is positioned favorably the spine
sions for abnonnal pregnancies can be made in this Qln also be detected by ultrasonography in the thoracic,
manner. Sizes determined by fetometry can be used to lumb.lT, sacral and even cocg.'geal regions. Usuatty the
assess gestational age in cases were uncertainty exists typic,,1 double row of hypcrechoic discs is apparent.
aboulthe exact service date. Transcutaneous ultrasono- Only the tail vertebrae pTlXlucc a single row of solid
graphy through the dam's ventral abdominal wall may echoes.
prove useful in some cases in order to visualize the fetus
(AoAMS-BRENDEMUEHL and PIPERS 1987).
1.3.3,1.2 Thorax and heart

The COnic.1tty tapering images of the two halves of


1.3.3.1 Imaging of fetal organs the chest cavity arc obvious in the thoracic region (Fig.
The ultmsonic appearance of the various organs of 1.86). Similar to the \'enebme, the cross sectional im·
equine fetuses generally resembles that of bovine fe- ages of the ribs produce echoic circles. Ultrao,onic shad·
tuses (Sec Chapter 2.4.1). In the latter species the ultra· ows lie behind the ribs that produce them.
sonography of the fetus ha<; been well studied. Below The heart will be evident in the apex of the thorax
follows a description of particularly characteristic ultra- (Fig. 1.86).The echoic wall of the heart surrounds the
sonic images of equine fetuses. hypocchoic lumina of the ventricles ;lIld i1tria which arc
separated from one another by bright val\'cs and septa.
The action of the heart c.1n be demonslr;lted quite im·
1.3.3.1.1 Head, neck and spinal column prcs.<;ively if the probe is oriented properly.
The m<;al heart rate of equine fetuses is 150 to 190
Prominent structures on the head of the equine fet us bealS per minute in the 3rd month of gestation and
are the eye and the cranial cavity (Fig. 1.84). The vito decreases slowly as pregnancy progresses (Fig. 1.87). In
reous body of the eye is anechoic and surrounded by the Month 7 the basal hean rate will vary from 100 to 110,
hypercchoic orbit. In the anterior portion of the eye ball and near term 60 to 80 beats per minute (CoU..E.S and
Arch shaped structures become visible. The t...,'o convex PARKES 1978, PIPERS and ADAMS·BRIONIlEMUEIII. 1984,
lincs that lie opposite one another represent the front MATSUI et at. 1985. ADAMS·BRENDEMUEHL and PIPERS
and back wall of the lens. 1987). Generally. however, the heart rate is mther "'Ir·
The roof of the scull ilnd the b;lsal portion of the iable and can rise well above the basal values during
brain cavity form a hypcrechoic, oval outline that is a short periods of observalion.

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62 Ultrasollogmplly ill tile mare

FIg.. 1.88: Tral\S\'ersc section through the trunk of II fetus on Fig. 1.89: Cross section through the umbilical cord with the
Day 148 of pregnancy. At the bonom lies the stomach (S), al two lumina of the umbilical arteries Lind that of the umbilie:tl
the lOp lies the coarsely granular, moderately echoic I~"!;!r (L), vein in a fetus on Day 185 of gcstatKm.
and between them runs the caudal caval vein to the right of
which is a cross section of II vertebra with II ultrasonic shadow
originating below it.

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Equine Jews 63

1.3.3.1.3 Abdomen and pelvic ngjon bilobular, hypcrcchoic structure. The optimal lime for
transrcctal uJtrasonographic sex determination in
The abdominal organ easiest to depict by ultrasono- equine feluses appears 10 lie between Days 60 lind 70
graphy is the stomach (Fig. 1.88). II fills a hypoechoie of gestation. The sex determination is possible at later
oval area in the background of the last few ribs and stages too. but then the more cranio\'cntral position and
shows the typical features of an equine stomach. namely the larger size of the fetus may make the optimlll depic-
the dorsal cul-de-sac and the ventral body. tion of the C'Judal body region difficult and not possible
Next to thc stomach lies the coarsely granular, in C\'CI)' examination.
moderately echoic liver which is passed by the black In contrast to lhe situation in bovine fetuses (see
cords of the large abdominal blood vessels (Fig. 1.88). Cllapter 2.4.2). it has not been possible to determine
Under optimal conditions it may be possible to de- the sex of equine fetuses by sonographic imaging of the
termine the sex of equine fetuses by means of ultra- scrotum (PlrERS and AOAMS-BREf'lOEMUEHI. 1984).
sonography (CURRAN and GtNTHER 1989). For this pur- One reason for this is that the testes descend much laler
pose the location of the genital tubercle between the into the scrotum in the equine fetus than in the bovine
hind legs must be determined. The embryonic genital fetus. Therefore. the depiction of the scrotum and
bud differentiates into penis and prepuce in the male testes cannot be used to differentiate between the sexes
fetus and into clitoris and vulva in the female fetus. Dur- of equine fetuses.
ing fetal development the genital tubercle migrates Occasionally. the umbilical cord which noats around
from its origin between the hind le~ cr... nially towards within the placental fluids can be seen (Fig. 1.89). A
the umbilicus in the male and caudally towards the tail trarm'Crse section through the umbilical cord shows the
in the female. By determining its position from about typical arrangement of two umbilical anerics and one
Day 60 of gestation the sex of the fetus can be diag- ,'Cin in the equine fetus.
nosed. In both sexes the genital tubercle consists of a

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64 Ultrasonography ill IIII! mare

~ = Fetus inaccessible
o = Head accessible
90
80
o = Thorax accessible
70 • = Abdomen accessible
60
% 50
40 folg. 1.90: The rrequency with
30 \\"hich the head, thorn.'( and abOO-
men of eq uine fe(uses (Thorough-
bn:d and Standardbred) were 3C-
tcS-\lblc by tran~Toctal sonogr... phy
during pregnancy (adapted from
3 4 5 6+7 8+9 10+11 !U.II.'J and WOI. 1987 a).
Months of pregnancy

Estimation of the age of equine felulieS and pn:gnallC)'


throuGh $OOOgr:lphic fetometry ,
90 , .
90
.I
"
SO
: " 80
iTnmr i
"
7.
, II
:
" 70
I -/ Braincase

"
60
,
"
60

" =tl
-
50

, /Stomach I 50
"
§45 - i 45 §
o
40 - I I • /' 40

" I-I---t ;-j "


~

/ 1
JO 3'
VEyt ,
,,
"
,
"
~

;
20

"
-H f ,
,
,
, , .
!
20

"
10
, ,
10
,
Rib diameter \\'iLh

o I f one intc:TCO:§l11l spa« ,


0
60 90 120 150 ISO 210 24{) 270 300 330
Days of pregnancy
Fig. 1.9 1: Growt h (regressions) of Ihe largcsi diameters or the Fig. 1.92: Example o f IlIking measurcmenls of the diamclers
tru nk. braincase. stomach. eye :and one rib cross SI.'Ction with of cye and braincase in a fClus on Day 159 o f pregnancy,
one inlercoSial space in equine re tuses (Thoroughbred and
Standardbred) during pregnancy (adapted from KAlIN and
1..£101. 1987 a).

Ay S ozas 10
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Equine Jews 65

1.3.3.2 Accessibility of equine fetuses by Clition of thc ultmsound probe (O'GRADY et al. 1981 .
transrectal sonography PIPERS and ADM1S- BRENDEM UEI U_ 1984). By"pplying
the probe in thc area between the maternal udder :md
During onc study involving 162 Thoroughbred and na\-cI feta l structures in the proximity of the abdominal
Trollcr mares which we~ 3 to 11 months pregnant it wall can be visualized from the outside during the 2nd
was possiblc to reach thc fc tus by transrectal sono- and 3rd trimesters of gestation. Using this tt.ochnique the
grdphy at all stages of gestation (KAHN and LEIDL 1987 trunk of thc fctus remains acressiblc until binh.
a). For these examinations a 5 MHz lincar ulliJ.SOund
probe with a penctration dcpth of to em was used. The
technical difficullics associatcd with the ullrasonic ex- 1.3.3.3 Sonographic fetometry in horses
amination of cquine fC\l!scs very much depend on the
stage of gestation. In about one half of thc mares ex- Through fet ometry. ultmsonogmphy offcrs the p0s-
amincd between Days 80 and 100 of gestation the fe- sibility of dctermining fetal agc and to lLSSC'iS the dcvel-
tuses lay outside the range of the ultrd!iOund Wolves (Fig. opment of the fetus and pregnancy (KAliN and LElDl
1.90). At this stage the relatively small fetus had often 1987 a). The best apPfO<tch for measuring a fe tus de·
descended cranioventrally into the uteru.<;; bulging far pends o n the approximately suspected stage of preg·
beyond thc pelvic brim. In this position it was too far nancy. In principal it is expected that the combination of
away to be detectable by the ultrasound waves. From measurements from as many parameters as possible will
the 4th month it became increasingly ca<;;ier to reach result in the most accumte estimation. Until Month 6
some parts of the fetus so that only to to 20 % of aU the diameter of the trunk and the size of any additional-
fe tuses betwecn the 5th and 11th months of gestation ly accessible organs should be determined. From the 6th
remained beyond reach. month especially thc head should be fetometrically cval-
The availability of individUltl fe tal body parts for ul- uatcd. On thc procedures for fc tometry sec also Chap-
trasonic examination also depends heavily on the stage ter 2.4.4.
of gestation. The head will move closer to the maternal
pelvis as pregnancy progresses and was visible in 74 to 1.3.3.3.1 Eye and braincase
83 % of all 6 to 11 month old fetuses in thc above mcn-
tioned study (Fig. 1.90). In contrast. the thorax. abdo- The cye is the feta l organ which is most frequen tly
men and pelvis generally move Cl.'cr furthcr away. The available fo r fctometrical assessment during thc entire
chest and abdominal regions were accessible in 25 to 50 course of gestation (Fig. 1.90 and 1.92). The largest di-
% of fetuses during the 3rd. 4th and 5th months and on- ameter of the eye increao;cs approximately in a linear
ly in isolated cases thcreafter. fashion as pregnancy progres.o;cs (Fig. 1.91).
The above mcntioned rcsull<; reflect tendencies and The expansion of the inner diameter of the crdnial
can be impl'O\'Cd significantly through the development cavity increases vcI)' mpidly (Fig. 1.91 and 1.92) and is
of beller ultrasound technology. With impTO\'ed tech- well correlated with the stage of pregnancy. The brain-
nology equine fc tuses and their body parts will then case can only be measured until the 8th mont h of gesta-
become even more available for sonogrnphic examin- tion. because thereafter the sound "''aves are too at-
ations. It has also been demonstrated that thc shon- tenuated by the cranial bones and thc imaging field of
comings of trdnsrcctal sonogmphy could be com- conventional SC'dnners is too small to allow the crdnium
pensated for in many cases by the tmnscutancous appti- to be depicted in toto.

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66 U1ffflSonogmphy in fh e mare

"'ig. 1.93: Exnmple of taking measurements of 3 nb cross sec- Ag. 1.94: Example of measuring the dill meter of the lruolo: of
tions ..... ith their rom.-sponding intercostal spaces in a fetus on a fetus on Day 88 of gesta tion.
Day 188 of pregnant),. TIIC length of one nb cross St:clion with
its corresponding in lcn.v.;tal spao.: i~ 12.5 mm (37.5 divided
by 3).

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Equille/ems 67

1.3.3.3.2 Ribs, trunk and stomach greatest length of the stomach. Now the largcst inner
diameter of the hypocchoic lumen of the siomach can
In order 10 determine the increase in the size of the be measured.
tmnsvcrsc scClions through the ribs, one must obtain a The largest diameter of the trunk is delennincd al
horo..ontal sonogmphic plane through the chest thereby Ihe level of Ihe stomach :md liver. The direct distance
making it will be pos..c.ible to count the number of ribs bet\\\.'Cn the opposing body walls on a sonogmphic
and imeroostal spaces per unit length (Fig. 1.93). In or· planc Ihal is vcnic-..ally oriented to Ihe lrunk is measured
der to reduce the errors in measurements to a mini- (Fig. 1.94), On avcmge. the diameter of the trunk grows
mum, scvcml ribs and thcir intclcostal SlXICCS (3 to 5) from 25 mm on Day 60 to 80 to 100 mm on 300ut Day
should be used for this assessmcnt. The di.<;tance be· 150 (Fig. 1.91 ). During the Momh 6 thc size of the
tween the edges on the same side of the cross sections of trunk exceeds the penetration depth of the ulll'll.<;()und
two distant ribs is delemlined. When this dist:mcc is di- probe and can no longer be used for fClometrical pur-
vided by the number of rib cross sections included, Ihe poses. Umil thc 5th momh of gestation thcre is nomlal-
result will be the length of one rib cross seCiion with its ly very lillic variation in the trunk diameter of different
:ldjoining intercostal space. fetuses. making this a reliable parameter for the assess-
The size of the stomach can be measured by orien- ment of fetal dcvclopmem .
tating Inc ultrwiound probe to show the image with the

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68 Ultrarollogmphy ill the mare

Fig. 1.95: Onset of e mbryonic mortality on Day 17 of gesta· F"tg. 1.96: Abnormal pregnancy on Day 27. The embryo still
tion. Signs of abnormality are the iocreasc:d cchogenicity o f exhibited heart beats. Signs of the impending embl)"OT1ic
th~ e mbryonic nuid as " "ell as the vaguena<i of the interface death were the irregular outline of the embryonic vesicle a nd
bet ....-ecn the embr),onicvcsicJc and the u te rine wall. Fou r days the smaller than expected size o f the vesicle ",.. hen rompared
la ler the ronccptus \V35 largely resortx:d . to the last service date.

....ig. 1.97: Abnormal pregnancy from Fig. 1.96 on Day 33. The
embryo had continued to grow Ilnd still had 8 beating hew.
Signs of cmbl)"Onic mortality are the uncharacteristic orienta-
tion and disorganization of the placental membranes (arrow),
the echoes visible inside the nuid and the small size and nat
shape of the vesicle.

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Ulerine palhol~ 69

1.3.4 Uterine pathology In the case of a disrupted pregnancy the loss of the
embryonic vesicle's tension is associated with a loss of its
1.3.4.1 Embryonic death typical shape. In the intact pregnancy the conceptus re-
mains strictly spherical until Day 15 of gestation. If the
In the horse embryonic death occurs in 4 to 15% of embryonic vesicle assumes any other shape before this
all pregnancies becwcen Days 10 and 50 (OIEVAUER day it should be suspected to die. During later stages a
and PALMER 1982, SIMPSON et a1. 1982, VALON et al. change of shape can no longer be used as a reliable in-
1982. SoUIRES et al. 1988). dicator since physiological changes in shape occur sub-
There are numerous ultrasonic signs that can be sequently. In some C3SC'i of embryonic mortality a disor-
used to predict an impending embryonic mortality. In ganization of the embryonic membranes have been 0b-
principle, all findings that indicate a deviation from the served (Fig. 1.97). Deviations from the typical
normal should be interpreted as suspicious. Certain fea- arrangement of the allantoic yolk sac membrane occur
tures are, hO\\--evcr, more characteristic and occur quite in some cases of embryonic death during the ascending
regularly. phase of the embryo (GI1-.TIlER et al. 1985).
An important feature indiCl.ting the viability of a The lack of a heart beat is the most reliable sign for
conceptus is the anechoic nature of the placental fluid. embryonic death. Shortly before death a bradycardia
In the case of a resorption slight to moderate reflections can be seen in somc embryos. In the intact embryo the
will appear relatively soon within the fluid of the em- heart rate is usually above 150 beats per minute.
bryonic vesicle (Fig. 1.95). They are a sign of the in- Anothe r indiCl.tion that an embryonic death might
creasing cellular content of the embryonic fluid and of be in p~ is the inadequate size of the vesicle
the disorganization of the placental membranes. (small-for-date) due to the subnormal volume of em-
The interface between the embryonic \-csicle and its bryonic fluid (G1NrnER el al. 1985). An embryonic re-
surrounding endometrium is smooth in the C1se of sorption occurring during the fi rst 3 weeks of gestation
intact pregnancies. When this line becomes wavy it may usually runs a rapid course. It only takes a few days from
serve as an indication that an embryonic death is immi- noticing the fi rst signs of a disorder untilthc e mbryonic
nent (Fig. 1.96). Occasionally, the interface appears tor- vesicle has disappeared. After the 3rd week some re-
IUOUS in which case the resorption will have already pro- sorptions run a protracted course (Fig. 1.96 and 1.97).
gressed somewhat. The reason for this is the lack of in- In mares that loose their embryo at a hiler stage, a pre-
ner tension in the vesicle which is Cl.uscd by cessation of ceding subnormal vesicular size ponends impending
embryonic fluid production and by its increased resorp- dcath. The involved embryonic structures somctimes
tion. The endometrial folds are no longer stretched continue to grow for several days and rarely for a few
smooth by the conceptus , but rather protrude into it weeks (DARDIIUS et al. 1988) yet do not obtain a
(SoUIRES et al. 1988). normal growth rate and eventually die.

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70 UI/rrlwllogroplly ill 'he mare

Fig.. 1.98: Uterus 4 days aCler the death of the fetus on aboul Fig. 1.99: Hydrops of the placental membrJnes in a mllre al
Day 70 of pregnancy. At this time the fetal fluids had largely
disappeared. Uypcrcchoic fe tal remnants (a rrows) ....'Cre still
dctt.'Clable b)' ullr.l.sonogrJphy for another 2 weeks.
day 230 of gestation. The c.V'CUio.'C aCCllmulation of flu id can
be secn to extend beyond thc ma:umal penclrnlion dcpth of
the sound w-..wcs. Thc fetus could not be de tected by transl'l'C-
I
tal uhra'iOnography .

•~ 1.100: Uterus (a rrows) of a mare with a normal postp.u- .'Ig. 1.101 : Normal involution of the uteru.~ in a mllre IS hours
tum period 84 hou~ (3.5 da)'S) after p.lr1urition. Within the fJOSt panum. The uterine lumen is largely closed. A small
uterus the ant.'C hok: lochial secretion ~pamling over a few amount of h)'JXlCchoic flu id is visible between the endome-
cc ntimetc~ can be seen. trial folds.

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A bllonnai pregnanc),. POSI paT1l1f11 /IIems 71

1.3.4.2 Abnormal pregnancy 1.3.4.3 Post partum uterus


There can be many signs of abnonnal events during During the fi rst k-w days of the post partum period
advanced pregnancy. The shape and size of the fetal sac the uterus of most mares contains some lochi'll secre·
can no longer be assessed. because it has become too tions. The depth of the fluid accumul;ltion can re,lch
large. Ultrasound ex...minations at this stage ameen- several centimeters, even in normal postpartum mares
trate on the fetus (see also Chapter 1.3.3). In cases of (Fig. 1.1(0). It sometimes happens that on the basis of
imminent abortion it has been noted that the fetus had an ultrasound ex..mination a uterus is found to be frcc
a heart rate beyond the outer limits observed in intact of fluid during the first few days after parturition (Fig.
pregnanCIes. 1.101); not infrequently, however. lochial Ouid may be
Often the fetus is not immediately expelled after it found in the same uterus during a follow·up examina·
has died. A steady decline in the amount of placental tion Ito 2 days later (MCKINNON et al. 1988). The pro-
fluid can be obser....ed by ultrasonography in such cases. portion of mares that do not have any Ouid left in their
The sonoanatomy of the fetus also changes. Many struc- uterine lumina increases significantly after Day 7 post·
tures that can be seen in live fetuses become less clear partum. At the time of foal heat only 25 % of mares
(Fig. 1.98) . Parenchymatous organs in particular. which have lochial secretions in their uterus. In the case of an
undergo rapid postmortem changes and are nonnally abnormal postpartum period with Ihe retention of
traven;cd by a rich supply of blood vessels change their lochia the resultant nuid accumulat ion in the uterus can
typical appearance (STAUDAa-t 1986). The hypocehoic be strikingly extensive and many centimeters deep (Fig.
appearance of blood vessels changes to look like the
surrounding tissues. because of intravascular roagula-
tion of blood. Soft tissues may loose their typical struc-
ture and look much less differentiated. Ossified bone
segments retain their eehogenicity and will therefore re·
main visible for a much longer period of time. Even
once the placental fluids have totally disappeared fetal
echoes can usually be found for several more .....eeks
(GINrnER et al. 1985).
In hydrallantois and hydramnion cases the most 0b-
vious finding is the extensive amount of fluid in the uter-
us. There is an excessive aceumulation of placental
fluids between the uterine wall and the fetus. In some
instances this is so extensive that it exceeds the scanning
depth of 20 to 30 em of low frequency ultrasound (Fig.
1. 99) and the fetus can not be reached transrcctally.
During transcutaneous examination it might be detecta-
ble in the vicinity of the maternal navel.
Flg. 1.102: l.ochiomelr:l in a marc 45 days poslpanum. 1hc
fluid pool in Ihe ulerus (arrows) exlends nmn)' cenlimclCf'j
dccp. lbc same day 1.5 1of flu id \.\'CTC dra ined rrom th is ulerus.

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72 UilfflSOllography ill the milrl!

Fig. 1.103: Pa<itpanum uterus (alTOllo'S) 3 days lifter panuri- J.1g. 1.104: Conspicuous accumulation of hypercchoic SCCTC'
tion. There is hypercchoic lochial fluid in the uterine lume n. lions (betwecn the CfOOiSCS) in a uterus with abnormal in\ulu·
The hyperechoic structurcs brJnch out O\wthe surfaccsof the lion in 1\ mll re 8 days postpilnum. Malin&" during foal heal
cndome trial folds. and the next heat did not result in 1\ pregnancy.

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Post partl/It! lIIems 73

1.102). The cchogenicity of lochia slowly decreases over Only few of the puerpcml mares which have seere·
the fi rst few weeks of the postpartum period. Immedi· lions in thcir utcri during foal hcat m the time of mating
ately after panurition the tissue componenlS and in· conceive (Fig. 1.1 (4). In contr.l..St, murcs that have a
fl ammatory products contained in lochial secretions solid uterine image at the same time huvc a much bener
cause the lattcr to contain floccu lar cchoes. These reo prognosis (M cK1NN0 1'l ct al. 1988). In tcrms of pnlctical
flections can becomc vcry intcnsive in cases of viscous. stud management this means that only mares which do
purulent lochia. Sometimes the luminal epithelium also nol show any ultnlsonic evidence of intra·uterine flu id
produces hypcrcchoic reflections (Fig. 1.1 03). The should be bred at foal heal.
superficiallaycr of the uterine wall forms a nnlTOW I to
2 mm, 'o'ery hypoechoic seam which lines the uterine
lumen and spreads behlleen the endometrial folds.

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74 UIlrrlsollq.'T"llpily ill the mllfl!

Fig. I.I OS; Trunwcf';C section through the mcrine hom (II r· Fig. 1.106; Uteru.~ of a marc wi th large accumulation or exu-
rows) of a Illare wit h chronic endometritis. 1bc lumen oon· da le a~ II result of Il chronic cndometrit~ The cndumctrial
tains a modciJ lc IlmoUn! of C'CUdaIC. folds bulge into the lumen.

Fig. 1.107: Uterus (affU\\"i) wilh an inflammlllOf)' kcrl.'lion as folg. 1.108; Uterus (a/TOYo'S) of a marc after the instillation of I
u result of II chronic endometritis. The increased cdlulur exm- I physiologic:ll s.aline -.olution for Oushing. The ai r bubbb in
Icm or lhc cxud:lle c;J1I~ Ooocular echoes. the Oushing solution produce intense floccu lar echoes.

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Urcn'lIc pml/Ology 75

1.3.4.4 Endometritis late shaped protrusion of the endometrial folds into the
placental membranes can be found even in intact preg-
Accumulations of fluid inside the uterine lumen arc nancies. The cases thus far identified all occurred in ol-
very typical of mares suffering from chronic endomctri· der. multiparous mares. The irregular interface be-
tis. The amount of fluid in Cll" of uterine infections tween Ihe embl)'Onic fluid and Ihe surrounding uterine
varies from marc to marc (Fig. 1.105 to 1.101). The wall appears 10 be a consistenl finding in all cases of em-
amount of the secretions in the same marc can also vary bl)'Onic death.
from day to day. This is dependent on the stage of the A typical feature of the uterine secretion in Ihe case
cycle. Auid accumulations found during estrus may be of endometritis is the increased echogenicity of Ihe
physiologic, but may also be an early indication of e n- fluid. Clear fluids usually produce an anechoic. black
dometritis in many cases (ADAMS et al. 1981). When- image on ultrasonography. In contrast, the secretions of
ever fluid secretions arc found in the uterus during di- endometritis mares always contain echoes of varying in-
estrus they should be regarded as abnormal. Sometimes tensity. Depending on the degree of change thc.'OC can
the secretions arc concentrated in a panicular area of vary from occasional floccular echoic spots to echo pat-
the uterus and at other times they can be detected along terns that can be more echoic than the surrounding
the entire uterine lumen. uterine wall. Small air bubbles ins.ide fluid accumulations
The outline of the flu id accumulations in e ndometri- can also produce noccular reflections. These are particu-
tis cascs is typically stcllate shaped (UlDl and KAHN larly evident after uterine infusions or flushes (Fig. 1. 1(8).
1984) in a tmnsvcrse section of a fluid fill ed uterine From a differential diagnosis point of view it should
hom in which the endometrial folds bulge into the uter- be pointed out that amniotic nuid can also be echoic
ine lumen (Fig. 1.1 06). The interface bet....'ee n the during Ihe 2nd and 3rd trimesters of gcstation. Due to
secretion and thc surrounding uterine wall is wary. the increase in cellular components it is first floccula r
Quite frequently the 6 to 8 cndometrial folds that are and later the amniotic nuid will have snowy reflections.
normally prescnt in the uterus of a mare can be seen. This also applies to the allantoic fluid during the last
The flu id distention of the uterus causes fluid to also trimester of pregnancy. The sonogrnphic differentiation
penetrate in between the longitudinal folds, separating belWCen the secretion of an endometritis and othe r
them from onc anothcr whereas in the absence of any fluid types in the uterus such as placental fluid or thai
fluid they normally lie in tight apposition. contained in e ndomelrial cysts. must be undertaken in
The stellate shaped appearance of the sonographie conjunction with the aw-ssrncnt of other criteria. Im-
cross section of a free intm·uterinc fluid accumulation portant criteria in this regard are the (."chogcnicity of the
in cases of endometritis cannot be secn in flu id accumu- fl uid. its intra-uterine position and its shape. The most
Ialions of other origins such as in inlact pregnancies or suitable time for the ultmsonic diagnosis of an endo-
with endometrial cysts. Due to the inner tension of the metritis appears to be during the mid to latc dies trous
placental membranes or endometrial cysts these form period (ADAMS et al. 1981). At this stage of the cycle,
rclattvcly tightly filled vcsicles which stretch the fold.. of pathologic fluid secretions seem to be most prominent
the e ndomctrium [ 0 form smooth lines. The interfllce and can stj]) be diffcrentiated from the possibly physio-
between the uterine contents and the endometrium logic secretions that may appear during estrus.
thus fomls a smooth line. In rare individual cases a stel-

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76 Ultrasonography ill the m(lre

Fig. 1.109: Pyomet ra in a marc. The uterus is severely dis- .lg. 1.11 0: Uterus and urinary bladder (all'UYo'S) of a mare suf·
tended by a large ilnlOunt offluid. Due 10 the large numbe r of fering from SC\'ere endome tri tis. The ut erus. with its endome·
leukocyte the purulent exudate contains very snow}' refll'C' trial folds bulging inlO the lumen. lies cranial to the urin ary
tions. bluddcr .

•'g. 1.111 : Tm nwcI"SC Sl'Ction of both uterine hams (a~'S) .'!g. 1.112: Urome tra in a mare. The uterus ClItends cranially.
of a mare suffering from muoomctra. The hypocchoic Sl'CfC· The intra·uterine fluid contains snlMY re flections such as can
tion is sUlTOUnded by the thickened ut erine walL A persistent be also \)p ical for equine urine.
hymen in this 2 year old mare caused the retention of fluid in
her uterus and vagina.

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Ulerine palllolOf{)' 77

1.3.4.5 Pyo-, muco- and uromctra be made 10 find floating segments of the amniotic mem-
brane or other fetal structures such iL~ the umbilkal
Pyometra represents a particularly SC\-ocre form of cord or paJ'lS of the fetus itself.
endometritis. Its ultrasonic image features an extreme The ultrasonic diagnoses of muco- and urometra are
dilatation of the uterus (Fig. 1.109). Through this the based on similar criteria as are used for a pyometra.
endometrial folds are stretched and the interface be- Mucomctrd is occ'sionally diagnosed in mares with an
tween the uterine contents and the ....'all is smoolh. imperfomte hymen. Most oommonly the diagnosis is
Within the secretions of pyometra there are usually made in young fillies. After the onset of ovarian and
intensive renCClions which increase in density ventrally. uterine cyclic activity during puberty, the usual outfloy,·
This is caused by the sedimentation of increased of secretions from the genitaltmct is prevented by the
amounts of cellular components as ....1:11 as the increa· persistent hymen. This then leads to the accumulation
sing consistency of the pyometra nuid in the uterus. of the mucous secretions in the vagina and uterus.
The ultrasound image of the urinary bladder can Apart from typical clinical signs. such as the protrusion
look much like that of a pyometra (Fig. 1.110). Due to of the hymen from the vulva or the rectally palpable en·
the high viscosity of equine urine the luminal contents largement of the uterus. the ret .. ined fluid can also be
of the urinary bladder show an echo pattern with inten· demonstruted sonogrnphiclllly in severnl seClions of the
sive rencctions which can be confused with that seen in uterus (Fig. 1.111 ).
a pyometra. The appcamncc of the bladder can also be AnatomiC'dl changes of the genitalia. such as the
confused with a slightly cmnially dilated uterus. Since craniovcntml displacement of vagina and uterus in the
this can lead to misinterpretations. a pyometra should presence of an open cervix, can cause urine to flow
only be diagnosed if two completely separate, closely crJnially into the uterus and establish a ummetra.
opposed hollow organs can be demonstrated. It is im· Ultrasonically such a ute rus appears nuid·filled and
portant to dcpictlhe entire bladder wall without any in- widely dilated (Fig. 1.112). The charncteristic echogen-
terruption so as to ensure that there: is no oonncction to icily of equine urine often also leads to noccular renee-
the more cranially positioned hollow organ. tions in the uterine contenL.~ as in cases of urometra.
If difficulties are experienced in differentiating be·
tween a pyometra and a pregnant uterus effons should

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78 UltrusollogrulJ"Y in the mare

Fig. 1.113: Endosropic Vk..-W of a multilocular endometrial cyst Fi3. 1.114: Two enoomclriaJ cysts (C) within the uterus (ar·
in the uterine hom of a marc. In front of the cyst is some I'rcc rows) of a marc. Bo th c),sts produce an image which could be
fluid. indicating that the mare also has an endome trit is. confused \\ith an cmbl)'Onic vesicle during an ullnlSOund ex·
ami nation.

f1g. I.I IS: Large endometrial ~IS wi th multiple scpta in the t1g. 1.116: Endometrial cyst (C) and conceptus on D-.I} 29 of
uterus of a mare. The cysts were opened using a biopsy punch pregnancy. The cyst bulges into the cmbl)'Onic \1:sicle oon-
nnd thc marc conceived three weeks Imer. taining the embryo (E). The pregnancy continued 10 dc\'C1op
unt....·entfully.

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UlerillC JHllholOf:D! 79

1.3.4.6 Endometrial CYSlS a diameter consistent with the last reported service date
and a centrnl position in the uterine lumen are all symp-
Endometrial cysl<; are typically found in mares O\ICr toms favoring the diagnosis of a conceptu.c;. Mobility of
10 years of age (KENNEY and GANJAM 1975, KAsPAR et the vcsicle or the detectable presence of a heart beat in-
al. 1987. LEtDl et al. 1987). In this age group cysts can side the embl)1) will both confirm a pregnancy. The m0-
be found in 20 to 25 % of all mares. The 'l'SlS can be of bility of the embl)'O is usually evident until Day 15 or 16
lymphatic or glandular origin. Endometrial 'l'Sts can be and can be observed in most cases by scanning the ves-
single or multiple (Fig. 1.1 13 and 1.11 4). They can oc- icle for a few minutes (l£ml and GINTHER 1985).
cur in both. the uterine body and the uterine horns. It Indications of a cyst include an irregular or oval
seems possible that the cysts can affect the fertility of shape. the presence of scvernl compartments within
the mare. They do not. however. prescnt an absolute their lumen. or their multiple occurrence in the uterus.
obstacle to the establishment of a pregnancy, because Vesicles that lie eccentrically or intrnmurally in the
many pregnancies ha\'e been seen to develop quite nor- uterus should also be vie .....cd as cyst... Further indica-
mally in the presence of endometrial cyst<; (Fig. 1.11 6). t iolt~ that a detC(.'1ed vesicle may be a cyst include a
In isolated cases, where the cysl<; arc particularly large discrepancy bet.....een the observed and the expected
or numerous, they appear 10 cause embryonic mal- diameter (based on the 1.lst service dale) of the vts--
development by interfering with the normal implanta- icle or it.. failure to grow in size as dcmonstnlted by
tion process of the embryo (AOAMS et al. 1987). repeated examinations at intcrval~ of a few d:lYS.
UltrJSOnic·.llly. cysts look like fluid filled vesicles with If there is still doubt about the identity of a \,t.'Sicle.
a sh.lpe that can vaT)' from spheriC'.l1 to long and oval. other pammelcrs than Ihose established by uitf'.lSOIlO-
Their lumen can consist of a single cavity or can be di- graphy must be relied on. These include the nssessment
vided into severnl C'.lvitics (Fig 1.11 5). The outer ....'3115 by rectal palpation of uterine and cervical lone as well
and possible inner septa of endometrial cysts possess as the site and shape of a possible bulge in the uterus as
the same cchogcnicity as that of the uterine wall. The well as progesterone detcrmination. If even this cannot
rront and back walls of the cysts which are oriented vcr- provide clnrity, a repealed examination after a few days
tically to sound wa\'CS C'.ln show intensive, specular re- is indicated. If the mare is pregnant there will be a de-
flections. The cyst fluid, which is lymphatic fluid , is an- tectable increase in the size of the embryonic vesicle by
echoic and looks virtually black on ultrasonography. the time of the next examination.
The size of these cysts can vary from a few millimeters In order to avoid later confu.c;ion in differentiating
to SC\ICrnl centimeters. betwcen cysts and embryonic vcsicles il has been found
Some C)'Sts f'.lnging in size from 10 to 30 mm can at useful to look for the presence of 'l'Sts during a breed-
times be difficult to distinguish from Day 10 to Day 25 ing soundness examination which is performcd at the
pregnancics {OIEVAUER and PALMER 1982. SIMI'SON ct beginning of the breeding season . .....ell before the mare
al. 1982, LElDl et al. 1987). From Week 4 or pregnancy is bred for the IiDt time. During this cxamimltion the
thc differentiation is easier, because thc cmbryo exhib- presence, locality. number and size of all endometrial
itc; a beating heart (Fig. 1.116). Evcn at this stage con- cysts should be recorded. Should a new vesicle of the
fusion can arise whcn there are twin embryonic vesicles appropriate size appear during the lirst 3 weeks after
or simultaneously occurring cysls and a conceptus. SCrvK:c il ,"'Quid be most likely to be an embryo. Endo-
Paying particular aUention to the recognition of metrial cysts grow much slower than embl)'OS ;md the}'
their typical, specific features makes the distinction be- tend to remain sonogmphically unchanged for much
tween a conceptus and a cyst easier. A spherical shape, longer than embl)'OS.

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80 References

Refere nces 10 preface TAlNT\JRlu. D.. L. 1..I.Iooa. M. CHMIU. K. W. S.o.~llJAtlA d B. D&Ils


(1983.): Diq;no5tic de I. ~tion chc:z Ia brebis par 6cbotot'lOSnphie.
Revue Mt<! . vtt. 134. S23-S26.
Bcruo. a. F. M.uo."IAr-Ekn'Tt C1 F. CHE"'U~ (1984); DiagnosIic TA'NTVllIEl. 0 .. L. I..uoua. M. CHMlt. K. W. SA1DJAfoIA d 1.£ NErf
pi6coc:e de &' UMion par 6chographie d·lIltruonf,. Jour'llOh h<:h . Por- (1983b): Diagno5lic de I. acstation cht:z I. chh..., par 6chotomo&raphic.
o;i~ en ~ 16. 181 - 1S&. Revue Mt<!. ~ . 134. S97- S99.
8out.Er. D. (1982) : Application de l'6cho£l'Iphie III diq;nostic de TAVf.l.'II!. M. A. M .. a SZENCI. J. SWAQ and A. Pi_ (198.5):
Jallillon chez la chienM Braque de Weimar. BIIll. Acad. ~ . Fr. 55. Piq;tW>C)' diqnc:.sis in o;oQ wilh lineIIr-anay real-time ulll1l5OUnd
229-232. lK'IMioa ; • ~Iiminary tx*. The '«tt:rilwy Qtw1erly 1. 264-ro
CllAFl'AUx . s.. F. VA1..OtI d 1. MAlmN£Z (1982) : Evoilition de l'imllF VALOtI . F.. F. SEGAao CI .51:. CHAfflWX (198:2): &hcMomoJraphie en
6chogl'lphiqllc: du pn:w;IIIit de concelAion cllcz I, vachc. BIIII. Acad . vft . IC:llIpS 16::1 de J'ultrw chc:z Ia jument . BIIIl. Acad . vh:. Fr. S$. 1B7-211.
Fr. '$. 213-221. WHITl!. I. R.. A. J. F. RUSSEL and D. G. FowU!l (r984) : Real-time
CHE'AuU: . F. and E. PAl.lI~ (198:2); Ultrasonic: edql'lpby in the ul1t'UOllie scanning in the diqnc:.sis ol p~ and the due, ",;nation
mare. J. Rt;pnlll . ~n .. SIIppI . 32. 423-430. 01 fetal numben in iheep. \let. Rt;c. 11.5. 14{)-143.
DI Bou. c.. H. W. en M. A. M. T...... ElNE (I984): Dnchlighcidsonder- WHITl!. I. R.• A. J. F. RII5SEl.. I. A. WlOOHT and T. K. WHYnI (1985):
wo:k bij he! I('hup D. M. V. twce-dimcnsioncle cdlOll1lf~. VIAmI ReaI 'lime 1I11t'U011ic scanning in the dil;gnosil 01 prcpatKY and die
dic:,&fl'1iCUk, TIjdsdlr. S3. 240-2S2. estimation ol, ·,mional.,e in eattle.. Vet . h<:. In• .s-s.
DoNALD. I .. J. MH:VICAI and T. G. BJiOIo'tI (19S8): Irr.oesIiption of
.Woi,';na! ma5:11:S by pIIlxd 1I1t11l11Jllnd. ~ I. U3-I19 I.
Foovu.a. D. G. and J. F. W,UlJ<5 (1984): Diqnosis of prqnancy and
iIIImbcr 01 foo~ in .tJcep by n:al-time IIllBS011ic iml,ioa. I. Efkcts
ollllllJlba 01 foenuc:s. IIqC ol i' ation. opcl1llOl' and breed of ewe
on .mJrky ol diqnosis. U,,3wck PnidllCtion Scicntt II. 437-4so'
G ' IffllU . a J. (1913): Fiution and oricnwion ol the early equine
conceptus. Tbc:rJoaeooIogy 19. 619 623.
G'IffllU: . a J. and R. A. PiERSON (1984): Ultrasonic lllltomy ol
cqui~ OO'lIrles. Tbc:rio&enology 21. 471 48)
1JoiAaA.. T.. Y. NAltAZlWA. N. MATSlJI and T. I~ (1983): Early Rcferences to chaptcr 1
prqnancy diagrQis in JOWl by IIlullDilic linear elec:tronie 1K'IMi...
TheJio&cnokv 20. 97- 101.
'III!. M .• K. OtiW(Jll) and S. KuWlOA (1984): Diagnosis ol prqnancy A/.Io\MS. G. P.. I. P. K.o.srEuc, D. R. BEfIGfRT and Q 1. O tN'THU:
in pip by real rime uJtruonie B- mode ICan. Jap. 1. _ch . Sci. SS. (198'7); EIJc,;t ol ull::rinc: inflammation and IIltrasonic:a1Jy-dcIcdod ute-
381-)s&' rine phlthoIogy on fen ility in the mare. I. Rt;prod . Fe" .. Suppl. 3.5.
KJ.HN . W. (1985) : Zur Trlchlipil$l.liaanose beim Rind mittcls Ultl1l- 44 5-454.
IChaiL lkdml. Urnsch. 40, <n~. A\lO.",s· BIE.'IOEMUElIL. c.. and F. S. PiI'EllJ (l9!7): Anlt:pl.rtum c:vaIua-
K.i.HN . W. lind W. LElDt. (1987): Ec~hc Befu.nde an Ovarien Iion$ 01 the equine fctw,. I. Rt;pood . ~n .. SIIppI . 3$. 56!i- .573.
¥Un Snllen. Ticliml. Urnsch . 42. 2'7-266. AI.I..£tI . w. E. and P. J. (loot>O.ao (1984): Serial inYes(iptions 01 carly
LAIBUN. c... s.. SoIM,1JT unci 1. W. DuoEtIHAUWi (1982): Emc Erfah- p<qnancy in pony 11111~ U$i", iUlt;me IIltrasound I('anni",. Equine
rungen mit dem ADR-Real -Time-Scar\ner tIIr TTkhli,keitsdiagnos.e bei vet. 1. 16. .509-.514.
SdW. $chwcin. Hund unci KIlle. Bert. Munch. lierirttl. Wschr. 95. Aunl . W. E.• P. E. AUfJD. K. KOOIOS and 1. F. PtCOt.." (J98'7) ;
<73-<>1. Ul\JU:lllic .~ oldie equine ~ haelllOl,I""ic\im. Vet. Roc.
I K ....ND . J. 1. B. C.o.wu:. I. BEJrrlAND d P. F. Vl.UD (1982) ; Ill. 422-4U
lmagc:t 6chognplUques de 1'anaIomic iIbdominaJc del ~iYOrn dol, ... BowMMi. T. (1986): UIlllSOOic diq;n05is and ~mcnl 01 early
"iques. Bu ll. Acad. vtt. Fr. SS. 223-228. twillS in the mare. Proc:. Am . Au. Equine Pracutr. 32. 35-U
LElDL W. and W. KJ.HN (t984): Diffen:nti I Ldi l anostitr.:hc Befu.nde bei CAitIIl!VAU!, E. M.. A. O. MCKif/NOl'f and E. L. SQtnIU (t988 .):
der Fr1lhukhtiJ:b::iutJnl!:l"$lIChiI,* ¥Un Stulcn mil dem Ullruchallver- EITttt 01 JIIllWIllatory IOllicular fluid aspiration upan luEal tur..-Uon
faill1:n (Echoaraphie). vlaami ~t . TijdlChr. S3. 1»-119. in the i1\;l~ TlI'''lcFnoIogy 29. 231.
MAlUlAt:. 1. M . • S. CHAI'FAlllI. 1. 1. lalilANll. B. Cuuu. d F. HEm.: C.o.aNEVALI!. E. M .. A. a McKltl_ and E. L. SQuJau (t988 b):
(1980); DiaallOllic de Ia V'hlion chez Ia chane; utiliwion de 1'6c;ho- UltraIOnic c~rUticI uf the ....-ut.tory follicle dlrocdy piUC:C:V
JI1IPhK. Rt;cl. Mtd . vtt. £c. A110rt lS6., 1199-907. ding and dun.. ovulation in the mare. ~ 29. 232.
PAl.lIU:. E. and M. A. DalANCOI./U (1980); Use ol ultruonic «110- C HEVAUU . F. and E. PALMU (1982): Uhl1llOllk ochosraphy in die
araphy in equiJoc 1)'TICCOIogy. llocriQsenology I.), 203-216. mare. I. Rt;piod. ~n .. SIIppI. 32. 423 ...... 30.
PiE........ R. A. and a 1. GINT1tU: (19841): Ul~ for dctco.:. COl, f t , c.. M. and R. D. p ",UI'S (1978) : Foo:taI cic<.:trocardqraphy
tion olplqllll'lC)' and ,"lIIy 01 cmbfyonic devclopi,ltnl in hcikn. The- in the marc. Equine vet . 1. 10. 32-37.
riQgenoiogy 22. 2ll-233. CullAN. S. and a 1 G,IffllU (1989); Ul\JU:lllic dilgllOlil ol equine
PrElSON. R. A . and Q 1. G,:ffl(U: (1984b): UIUUOIIOCl1Iphy 01 the fctaI $CX by location 01 die t;Cnital l\lbercle. J. Equine \'Ct. Sci. 9.
bovine ovary. Theriocenology 21. 49.s-~. n - 8l.
RUVES. 1. J.. N. W. RANTANE.'I and M. HAUSER (1984): Transrectal DAllN'us. K.• H. Kl""DO.H~ and A. MAOflI (1988): Clinical and cndoc:-
n:al-time ultruound scanning 01 the COW" ...,productive ,Tw;t. The. qc· nne snxIieI in I!IIml with ~ hi$tory ol repealed U)l4p1\1S losses.
noIogy 21. 485-49-4. Theriot:eoology 29. 1l15-1232.
StNI'SON. D. I.. R. E. S. G~EEN'AOOD. S. W. RJcurrn. P. D. Ross. G'Iffll~. a 1. (t983 I): Mobili!}' oldie early equillt ,oe4pcus.. The-
/.Io\U!. M. S.o.NDEa5ON and W. R. AJ..L.V< (1982): Use 01 uhruound riotenolol.Y 19. 603-611.
echoeraphy for early diq:1ID$.i.I. of l ingle and twin prqnancy in the 11111...,. GINT1t~. n 1. (1983 b): n · · lion and oricnwion ol the early equine
J. Rt;prod . ~n .. Suppl . 32. 431-439. UX4pi1l1. Tbc:fioaenoIos.y 19. 61)-623.

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RejtTl'lIces 81

0"<1'1101. 0. 1. (1984 I) : inlnIurrrine ItIIM:mrnt 01 ~ early roncq>IU.I lDnI. 0 . S. and Q I. (ir:ml1Jl (19M): Mobili!)' 01 tile COIICCjAlIJ and
in bamn .00 po6!p'"um mvt:I. Therqc:noiogy 21. 633-6'4. uoeri:w: a'lIIlrIICtions in tho: man:. 11k' """,ooioc 24. n - 711.
ClI1<T1l". 0. J. (1984 h) : Mobility 01 !Wid ~niIrY<IniI: _i<1<:o In mamo. MAnrn, K .• S. Suo:woo and I . M!.su......... (1983): Cha:oFs in tho:: &:cal
Theri0l<'"olagy 22, 8J-9S. he_" ralt 01 Thorouthbrtd t.or.c ohmotJh tho: gtSlI! ..... . lap. I. vet . Sci.
ClIl'ITlI". 0. J. (\984 t) : P\)QrLWioa ell1bt)o redI.IctioII in unilaleral 47. m-601.
.00 bilaw:ral !wiM in ~ ThcrioFnoIosY 22. 21l-211 M c KrsSOl<. A . Q . E. L. 5Quw3. L. A . H"IImON. E . L. 1kx1l..,.;l
ClI1<T1lEJI.o. J. (1986) : Ulrru.,..;c irnoainl..,.;l ..,pmdu<1iw: ew:nl$ in R. K . SII,,,,,, E. ( 198!1): UliJMlWllraphic: lNdirs on tho:: ..,pmducliw:
~ mm. Yerllc EqU.lKrvica. CIOSI PW .... Wisconsin , USA. . trlC! oI .... M Ifler p'ltIuitioa: EtJca 01 ilM>lution and IIICrine Auld
ClI1<TI\u. 0. J. and R. A. Pw.UOl< (19S4 I) : UI\r.uonif;: ~! ..... 01 ... poq1WIC)' me. in ....M with normal ..,.;l de~ rilll IQlponum
~ reproduc!iw: !net 0I~ = : OI"lriaI. J. Equine: .a. Sl;i . 4, ll-16. (MIlany qo<le$. I. Am • .a. mcd . Au. 192, 3~353.
(irl'lTllEJI. 0. J. and R. A. PrEasOrl (1984 b) : UI!monic anatomy 01 MEHt, H .. A.· R. G<lr<zu.. W. A!lf.LWId R. M"nos (198J): Eo::ho&>a.
equine (MInes. 11.,.iop:/ICIIasY 21, 471--4!1 phic - rine ElJinzu.. dtr IY~ UiiItnIidounpmetJooden
(ir1<Tl\EII, 0. J. ..,.;l R. A. PrEasoN (1984 t) : UltfQOnic arM -'O)' ..,.;l zur Zyklul"" und TTictlIilkc:ilidiapostili: lItim !'kid. DlKb . tierlml .
P'thoJkv of ~ equine uw:ntJ. The..""""o,"..,.. 21 , SOS-SI6. Wrlr. \lO, 22.5-230-
(ir.'<TlIU. Q J. . D. R. BEIiGaU". 0. S. Lam .00 S. T. Sa.uo. (1983): O·Gum , 1. P. . C H. YI'..«IEJo. L. FtSIll.J!lOl'l. J. B-..I<.oo 0 . E5aA
Embo)Od;': loll in ....."el: ;""idt.o::e .00 ulrrasoni< rnorpboIosy. fherio. (19111): In u~ro vi$uaJi>Mion .. tho:: feul hone: by uluuoni< KMni",.
FnoIocY 24, 73-16- Equillt I'ract . 3. 4S-49.
!-to w r_ , D. (19S4): Physik WId ThduIik dtr U l tratdW l . ~ . P"L/oIEJo. E• ..,.;l M. A. Daw<cooIlT (1980): Us.:: 01 ultruonlc echo-
1'1: o;e Ullruchalldilgnollik in det SI;~. Hnc.: H.-J. Hoi · Jl'lpIo)' in equine IYnecaIosY. Tlw:riotcnoloc U. 203- 216..
Iindor. VerIt& Urban a. SdrwanIerIbc~. Milnc:hrn. Woen . BalirrTlOn:. PrEMOf<l. R. A . ..,.;l a. J. OtJmlO; (19U I ): Ultraooni< .....JIIII..... of
H"YES. K. E . N. . R. A. Pru.!ot<. S. T. Sc!tAa. .00 a. J. CIDmiu tilt corpus lult\lm of tho: ......... ~ 23. ?J}-806.
(1983) : EflI:ctsoi estrow q<:1c..,.;l lea..., ... ultruonlc""';ne lnatomy PrEJt3Ol'l. R. A. and Q J. On<rnEJo (1985 h): Ulrruonic e>'IJllllion 01
in maru. The.iop:nokJsy 24. 46S m . tho:: prc<MI!atory IOIlil;lc in tho:: ......... Theliop:noI"I)' 24. 3S9-368.
10...1<, W. ulld W. UJoc. (19SI) : 0;. UluuduJld"-ik (Et/q.ra· PrE.UON. R. A . .00 Q J. GI)(f1l1J1 (1987) : Follicular populalion dy ....
phie) in dtr IYnikokJcUchrn U........mU"l der SNit. Toerliml . Pru . micIo oIurin& tho:: e:ltroool q<:1e 01 tho: man:. Anim. Re!"vd . Sci. 14,
12. 203-210. 2t9-231.
10...1'1 , W. ulld W. UJoc. (19U) : SonopapItlKhe Bd.tndc am UlltntS Prrw. F. s. and C S. An.ws·BI!a<IlE.WVEHL (19114): Techniquesilld
'00II Snnc:n mit Ulrrudlall meiner F~....., S Mtphmz(MH.). :tppIimioRJ 01 tllllSllbolominaJ ultRlOliOJraplo)' in ~ I'ft'&IW'l mare..
Nc:,dcl.,ilkundr: I. 239- 246- I. Am vet . mcd. Au. Iss. 766-nl.
IUHs. w. WId W. ' fAA (1987 I) : Die: uttrudlall-Bionw:tric: _ Prer· Prrw, F. S., W. Zarr , R. HOI u;'.oo A. ASMJrr (1984): UIuuorIo-
ddtltn in UI!em WId die 1Oi.......phisdw:: ~llu'" iII..,r Orpne:. atapIo)r as 1/1 "juncc 10 prqlIIIlC)' WOWIiltnU in tho:: man:. J. Am Yet .
DlKb. tiefln:1l . w.dIr. 94 • .109-Su. !toed. Au. 1114. 328-334.
IUHs, W. IIIId W. I O"ll (1987 b): Ec:~1It IIdi.tndt 1/1 o-itn SlwI'5Ofi. [). J.. R. E. S. CiltEDo"\llUlD. S. W. RlnETn. P. D. Ross·
_ SUiIen. TIefiJUI. Unudo. 42. 2S7- 266. ... tAl. M. SA.~DO!ON and W. R. AlllI< (19112): Us.:: 01 ulrmound
K.o.S!\U:. B. . W. ""..1'1. C. l..IrGl<CI WId W. lnDL (1987) : Enoolllcmum· ecbo&:raph)' for early diapolil oIli"lIe.oo t .... in pn:gnI/IC)' in tho:: man:.
Z)'IU:n bti StuItII. Tril I. P\)Q·!u..d:rn·UnlUlllCltuncrn: 'obftommtn I. RI:prod . Fat .• Suppa. 32 , 431 -4)9.
WId MorpIIoIope. Toetiml. Pru . IS. 161-166. 5Quw3. E. L.. A. Q McKrs _ and R. K. SH'DIl.f" (1988): Us.::
KEMin, R. M. and V. K. 0""""" (m5) : Sl;1ecIed pathoIosital t han· 01 ul!ruonoJraph)' in "'produaiw: 1I'III\I#n'k1ll 01 ""'"'•. Therqc: ......
p 01 tho: nwc Uk'f\IS Ind CMry. 1. Rep"xl . Fat.. Suppl. II lo&Y 29, SS-;U
ill-339. StAIJtW:H, A. (1986): FtWe AtllIOmic im Uhnsc:hall , Sptinp:r Ye,-
LEloc.. W. ulld W. 1U1II< ( 19S'): DillemlliaJdiapootixlw: IIcfundr: 1q, lI<r1in, H~l~, Nc-w York , t.ondooI, ~., Thtyo.
bti dtr Frilhuicht.ipr:itsunlt"""""llI '00II SUiIl:n mit dtm UluudWl. Tcoo'I«lH, D. H .. R. A. PrElUOf< and Q J. (ir)(f1lEJo (l989) : Ouo.--
..m.hn:n (EcIqrap/Iic). V ....... die,,,,. ok . TIjddor. S)' 1»- oiutioo 01 plas ... JIIC' Jilt""'" COioa:~tntioRf for !'NO diSlill(t 11111:101
n•. ~ ill ~ TherioFnoIoc 32. 191- 204.
l..fJoc.. W. .00 W. IUHS (19119) : Ult..,.,.,i< dwxItlistic$ of ~ V"WI<, F. , F. SoouD rI .51. C..... fflIUX (1982): ~"o.noph;" en
Iital conditions .. tIoe equine UItfUIi and (MInes. In: ~iI; Ulua· rrrror- t&1de l'om!ntS rna la junoenl. Bull . Iw::td. V<!I. Fr. S5. 11fl"- 211.
.....1Id and Ani .... RcprodllClioa . CIorrtft! 1bpitI in 'kItriroary Medi · WIlIT1I. R. A . S. and W. R. Aun< ( 1985): Ug oIuJllUOOnd ecl... ra •
cine.oo Anilllll Science 51. 21 - 35. Eds. : M. A. M. ~nw:.oo A. ph)' lOr tho: ditkrollliaJ diapoIis of I ......1_ oo:lJ ru""",r in I "",",.

.......
H. WillclMi:. Verlq KlU_B Aado:mic Publilloon. DonIrecht. aow....

lnDL. W. • Ii ItosIout WId W. 1U1II< (1987): EndometriWllZ)"Jlrn lIti


"""iN: K.. W.1. 17, 401-402
Wn~.
Yet.

thun;c:n Ubcr
K.i.H.~
die
.
WId W. LEloc. (19118): Sono&raPhifClit U""' .... •
prbulatorisclw: FoIllkc:lclllwi<tJllIII bt; der sw....
SUirta. Teil 2. Kl irilidw: UlIItf"JI>OhunF'" \\)o-t.)mnoen un<! 1Jedt!""",. DucI> . Ilcotml . Wkhr. 9S. J62- l6S.
TicrimJ . PIll. ~ 2.81 - 289. WOODS. 0 . L. . C. Ii B.o.n:/t. R. Ii HJ~~ and [). H. ScmA~n.
lnm, (l. S. and Q J. O.......u (J98(), Ouol"Olaeri ... jnn 01 ifttrautcrlne (19ILS): Recent >Ndirs relat;", 10 carty cnoboJOiii< oIeIIh in tho:: .........
mobil;!)' 01 tho:: eady eqIIitw: Cotoccpws. The~ 22. 401 108. """ine vet. I., Suppa. 3, I14-IJ7.

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82 UfftriWllogrophy ill 'lte CDII'

Fig. 2.1: Schemntic presentation of an ultr.1sound examination .'ig. 2.2: Sagillalscction through a non-pregnant uterus analo--
of the internal genital trdCl of a cow. usi ng a linear scanner. gollS 10 the cxamination plane in Fig. 2.1. The larger curva·
The ultrasound probe lies longi tudinally inside the n."ctum, ture of tbe uterus is de ma rca tcd by a~'S.
just dorsal to the Ulerine hom.

rIC, 2.3: Schematic presentation of an ullrasound examination rig, 2.4: Tmnsvcrsc seetion th rough a non-pregnant uterus
of the internal genital tmet of a cow, usi ng a sector scanner. analogous to the scanning plane in Fig. 2.3 and 2.63. The 4
Crdnial vi<:w of the pelvic canal. The tmnS\'CI'scly oriel\1ed ul· trdnS\'CT'SC SL'CtiollS through the ute rine horns are demarcuted
trasou nd plane produces a cross SCC1ion of the uterus ( I) and byal'1'Olo\'S.
urinary bladder (2),

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Technique of ultrasonography 83

2 Ultrasonography in the cow

2.1 Technique of ultrasonography ullrd.o:;ound probes inside the rectum without call.'> ing
damage. Experience has shown that the use of linear
in the cow probes holds advantages over the other types when
The ultrasonographic examination of uterus and organs in the ncar fi eld are examined. Examples of such
ovaries in cows is performed by transrcctal sonography. situations arc when the probe L~ held close to an ovary
The technical aspects of the procedure arc largcly thc or very closely above the uterus. It is difficult, however.
same as those applied in the mare (see OIaptcr 1.1). In to tum a linear probe a....-ay from the longitudinal axis
the cow, too, the cxamination is performed in a way and hold it more in a Ir.msvcrse plane of the animal.
similar to that of thc rectal palpation (Fig. 2.1 to 2.4). They are thLL'> best suitcd to examine scctiort~ parnllcl to
After thc rectum has been cvacuated and thc intcmal the longitudinal axis of the body (Fig. 2.2). In contrast,
genitalia have been palpated in the usual manner. the sector probes offer advantages when more distant
hand·held ultrasound probe is introduced through the areas, such as the fctll.'> in advanced pregnancy, are to be
anus and thcn advanced cranially along thc rectal floor. examined. Provided it is suitably constructcd, a sector
Gencrally, all commonly availablc ultrasound scan· probe can be turned far enough in.'> ide the rectum to
ners ( lincar, sector and convex) can be used for trans- allow tmosvcrsc views through the uterus to be dcpicted
rectal sonography in callie . The only condition for their (Fig. 2.4).
usc is that one must be ablc to manipulate thc chosen

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84 Ultrosollogropl,y ill the COli'

f.'ig. 2.5: Crnnial half of the urimu), bladder (fundus and "']g, 2.6: Caudal half of the urinal)' bladder (U) wit h its neck
body); u!lO\'c the fundus of the bladder is a mature corpus (Cc,,<bc \'CSiC:le) and part of its body (Corpus \'Csicac). Vcntml
luteum (demarcated by a/TOlOl'S). to the bladdl.:r lies the horizontally positioned. hypercehoic
pelvic floor (a/TOlOl'S).

..-", 2.7: Pammcdian section through the pek'ic floor (ar. Fig. 2.S: Saginal section through the uterine cc"i,.; ventrally
rows); parallel 10 the initial echo. and ~retching into the to the cclVi."lics the urinal)' bladder (U). Se\'CraJ ~'ClVicaJ rings
depth of the image, arc a sc ric.~ of echoes whil;h arc caused by (a/TOlOl'S) can be rcOOt,;n iZt.--d. In the center of the cervix is the
multiple rcflections (rc\'crtx:rotion artifacts) bctwl.:cn the hori1.ontaUy positioned. bright linear echo of the cclVic:J1 CJ·
sound probe and the pelvic floor. nal.

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Techniq/le of lIf1rosOIlOgraphy 85

Arter passing through the anus the caudal structures uterus. Occasionally, the utero... can also be found lat-
in the pelvis. such as vcstibulum and vagina, are only eral to the urinary bladder. When the uterus has been
poorly recognizable. Moving funh er fOlW'drd, the easily recognized. the probe is positioned above the intercor-
recognized neck of the urinal)' bladder will come into nua] space. In the case of a linear array SC"dnner with
view (Fig. 2.6), II produces the typical image of a hollow craniocaudal and dorsoventral sound be'lm the probe is
o rgan cont<lining hypoechoic Ouid and expands cranio- swiveled from side to side to produce longitudimll im-
vcntrnlly to fonn the body of the bladder (Fig. 2.5). [Igcs of the uterus (Fig. 2.2). When using a sector scan-
Ventral to the bladder, especially in the area of the neck ner. the operator can tum the beam through 90 degrecs
of the bladder, the petvic floor can be secn. Its bony and thus change the scanning plane fro m longitudinal to
components are evident as vel)' bright, a few millimeter transverse in relation to the body axis. In this manner
thick. structurc..... The Ooor of the pelvis fonned by por- transverse sections of the uterus can be obtained (Fig.
tio ns of the ischium and pubis, lies vinually horizontally 2.4).
in its cranial ponion and rises slightly in a C'd udal direc- After SC'dnning the uterus, the probe can be rotated
tion (N1CKELct al. 1984). Deep to the echo of the pelvic further late rally in order to visualize the ovaric.... In their
Ooor o ne can often see further echoes which run paral- nonnal position they can usually be reached by the
lel to it (Fig. 2.7). These are reverberation artifacts. sound beam and any additional digital fixation or re-
created by the multiple reOections of sound wavcs be- positioning of the ovaries is nOl necessary. C:lre should
tween the hypcrechoic bony surface and the ultrasound be taken to allocate each identified ovary to the correct
probe. side. Since the exact scanning direction during an
The cervix of the non-pregnant caw can be found at examination is nOl always clear to the operator and the
the level of the urinary bladder (Fig. 2.8). The cervical both ovaries may be positio ned rather close to o ne
structures that can be identified include the cervical another it may happen that the ovary found first is
rings and a central. hypcrechoic line which represents allocated to the wrong side. Only after both ovaries can
the cervical canal. Immediately cranial to the cervix. be identified in succession should they be llppropriately
usually in the midline, appear the body and homs of the allocated as belonging to either the left or right side.

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86 Ultmsollography ill the cow

Fig. 2.9: Comparison of the image qualilY between lower and ~1g.2.10: The S.1mc pregnancy as in Fig. 2.9 imaged al a fre-
highe r fn!quency ultrasound. Ult rasonogr.lm of a conceptus quency of 3.5 MH z. Details are less wc ll rcrogni7.ab1e than at
on Day 45 o f prcgnarx.y at a frequency of 5.0 M H7~ The cm- 5.0 MHz.
bryo (E) lics on the floor ofthc uterus and is surrounded by its
amnion (A).

Fla. 2.11 : Comp;trison of image quality bcf'A'ccn kM'er and Fla. 2.12: The same corpus luteum M in Fig. 2.1 I imaged al a
higher frequcncy ult rasou nd. Ultrnsonogrnm of a corpus lutc- frequency of 3.5 MHz. Size of the corpus Ju teum: 36.5 x 26
urn with a cavity imaged li t a frequency of 5.0 MHz. The out- mm: size uf il~ cavity: 25 x 18 mm.
lillC of the corpus ]uteum is indic'dted by arrows.

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Technique of IIltrasonography 87

When cow genitalia are examined sonographically quality 7.5 MHz ultrasonography can be used. Sound
the imaging of small structures, such as the embryo and waves at this frequency provide a marginally better
its thin embryonic vcsicle, intra-uterine fluid accumula- resolution than that obtained with 5 MHz.
tions as well as follicles and corpora lutea, is of primary The penetration depth of sound waves at 7.5 MHz is,
importance. The image quality generated by ultrasound however, only 4 to 5 em (HAssLER 1984). For this
at a frequency of 3 to 3.5 MHz is not adequate to relia- reason the use of high frequ ency ultrasonography is
bly depict early embryonic structures or small functional restricted to the examination of structures Ihat arc
structures on the O\I3rics (Fig. 2.9 to 2. 12). For these, extremely close to the probe. Sound waves at 5 MHz
the use of sound waves of a higher frequ ency is essen- penetrate about 8 to 10 em, thus allowing the examina-
tial. The resolution of ultra<;Qund at a frequency of 5.0 tion of the O\Iarics and uterus during early gestation.
MHz is high enough to identify vesicular structures with Since ultrasound at 3.5 MHz penetrates 12 to 15 em or
a diameter of 3 to 5 mm (DoBRINSKI and KREMER deeper it can be vc ry usefully applied in the later stages
1982). At the lo......er frequencies of 3 to 3.5 MHz vesicles of gestation or in cows with pathologically enlarged
of 6 to 8 mm can be seen. To further increase image gcnitalia.

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88 Ultrosonognl/)IIy ill tile cow

ng. 2.13: Follicle (F) in 3 row on the day of CSlru~ The di· Fig. 2. 14: o.'ary (large :UTO\.\"S) with an estrus folliclc on Ibe
ameter of the follicular ant rum is 17 mm. the thickness of Ihe dlly of ovulation. There is a echoic spot (small alTQW) li t Ihe
follicular .....;111 is I to 2 nlnl. Iklow the follick lies the urinary floor oflhe follicle. Ultrasonogrum laken with a 5 MI·lz SCt"lo r
bl:ldder (U). scanner.

.'higher
g. 2.IS:frequency
ComP'lrlson of inl<lge quality betwee n lo..... er and
ultrasound. Ultm..o;;cmogmnl of an estrous fol-
~'g.
2.((i: The samc follicle (Fb) :I." in Fig. 2.15 secn at 3.5
MUz. ·'be diameter of the follicle is 16 mm.
licle (Fa) at 5 MHz.

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Omriull Sin/Ctl/res 89

2.2 Ovarian structures in the cow arc found to lie next to cach other a dividing mem-
brane. consisting of the apposilioned follicular walls.
2.2.1 Follicles can bc dctccted. The wall of a follicle which is sur-
rounded by the hypcrcchoic ovari'lIl stroma can I'llrely be
2.2. 1.1 Sonograph ic images of follicles identified (Fig. 2.13 and 2.19). Thc thin follicula r wall is
OCC-.o.lSionally scpar.Jted from the OV;lrian p.1I'cnchyma by
The sonogmphic image of bovine ovarian fo ll icles is
a \'ery narrow. hypocchoic line.
char.acterizcd by the anechoic. circular areu of the folli·
The shape of follicles is usually round ( PIEKSON and
cular lumen (Fig. 2.13 to 2.20). During real time scan·
GINnmR 1984 b). The dividing walls of two neigh-
ning the sphcrical shape of the follicles can be demon·
bouring follicles of equal prcs.<;ure oflen fonn a stmight
stmled by moving the sound probe back and fonh over line. Sm:lller folliclc.<; often bulge into the lumen of a
the ovary. Their fluid contcnt usually cont:lins no re-
larger follicle.
flections ( PIERSON and Glr..'11IER 1984 b. R EEVES el :ll.
The limit of resolution of 3.5 MHz uhrasound lies at
1984). Only in ;t few individual cases the lumina of
6to 8 mm (PmRSON and GII\'11IER 1984 b) and cannot
follicles near ovulation will contain echoic spots close to
be used to reliably identify vesicular structures of less
the fol1icu lur w.all (Fig. 2.1 4). Whether these spots
than 10 mm (Fig. 2. 15 and 2. 16). low frequency ultm-
possibly represent the cumulus oophorus or structures
sound therefore only has very limited v:llue fo r the pre-
of iI different kind is nOI clellr }'CI. Where IwO vesicles
cise ex.amimltion of follicles on the ovary.

,
,

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90 U/trosollogmpll)' ill the cow

fig. 2.17: Bcwine oval)' during metestrus. Se.era) vesicles of fig. 2.18: (}.tary containing a cystic oorpus luteum (arrows)
varying sizes (from left to right : 4, 6. 8 ,md I J mm). AfTOI,\'S in· and a diestrous follicle 8 days after the last Q\'UL'llion. The
dicate the outl ine of the ovary. cavity of the corpus luteum is surrounded by a ...."llll of luteal
tissue. Dorsal and to the lefl of it is the diestrous follicle (inner
diameter: 17 x 13 mm).

Fig. 2.19: (}.tary ~ith 4 dC\'cloping follicles (I. 2. 3. 4) 5 days FIg. 2.20: Multiple follicles on an ovary9 days after the stan of
after the stan of a supcrovulatory F'SH trclltmen!. The row ECG induced superovulation. The cow received 3000 IU
was gh.'C n I\I-;ce daily injcdions of F'SI·! (6. 5, 4, 3 mg) for rour ECG 9 days earlier and 05 mg eloprostcnol 7 days earl ie r.
d:ar.>- The thin follicular wall surrounding the \'CSicies can be
rt!cog.nized in some of the follicles (No. I and 4).

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Follicles 91

Follicular vesicles with diamctcrs of more than 10 cavities in cystic corpora lutea resemble those of fol -
mm can be easily dctectcd using 5 MHz ultrasound licles. In contrast to the ancchoic follicular nuid. how-
(KAHN and LEIOL 1986). The accurate recognition of ever, the .mechoic fluid content of the corpus luteum
vesicles with diamctcrs of only a few millimctcrs de- cavity is surrounded by a modcrately echoic wall of
pends mostly on the image quality gcneratcd by the luteal tissue. which is a few millimeters thick.
scanner and on the experience of the operator. If the Follicular development can also be monitored ultra-
examination is conducted carefully. follicles in the size sonically in honnone induced superovulation (Fig. 2.19
range of 5 to 10 mm can still be identified reasonably and 2.20). In this way the number of developing follicles
accuratcly (Fig. 2.17). Under less favorablc conditions can be assessed reasonably accurately and their ovula-
the differentiation betv."Ccn several small, neighbouring tion with subsequent corpus luteum fonnalion can be
I follicles may not be possible in every case.
When counting ovarian follicles by ultrasonography
confinned (DRIANCOURT et al. 1988). The ultrasound
image of the individual FSH or ECG induced follicle is
there is a tendency to count 10 to 30 % fewer follicles in not differenl from that of a spontaneously developed
thc size order of 3 to 10 mm than are actually present . follicle . Only the overall picture consisting of several.
Vesicles with a diameter of less than 2 to 3 mm are too equally large vesicles is characteristic.
small to be detectable. even al the highest resolution of Afler ovulation has taken place. the ovulation de-
5 MHz ultrasonogmphy. pression. or any other sign of ovulation, cannot be de-
When carefully petfonned the ultrdSOnic detennina- tected. During early metestrus the echographic image
tion of the inner diameters of follicles corresponds of the ovary corresponds 10 that of an ovary without any
I quite cxactly to the real sizes of the follicular cavity significant functiona l structures. An ovulation can only
(QUIRK et al. 1986). The total outer diameter of the be detected in a cow that was examined by ultrasound
same follicle, including its wall. L" then 2to 3 mm larger. on the days preceding the ovulation, In such a case, the
From a differe ntial diagnostic point of view one must absence of a large vesicle, which had recently been
be able to separate the cavities of cystic corpora lutea present. indicates that an ovulalion has occurred.
from follicles (Fig. 2. 18). The sonographic images of the

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92 Ulrrowllogmphy ill rhe cow

~ "
-S-
U 14
.
12 1,1 1.)- ...........
L...argesl follicles
~
o 10
E , Second lugesl
E
~ 6 follicles -,.-
.!io •
E tlg. 2.2 1: The dc\-clopmeru of
.-" 2 the diamelers of Ihc largest
" 0 and second largest follicles in
o 1 2 1 4 S 6 7 8 9 10 11 12 Il 14 IS 16 17 18 19 20 heifers duri ng the estrous cycle
Days afler ovulation (from KAliN 198IJc).

2 follicular waves per estrous cycle


17 \7
_.
.--- "
~ Ovulation <:>
u ,, ~

Ovulation +
.£ .. ••••,..-." 3
~

~ II
0

E
Ll
+
... .'

.' .' .'
" .' '. ...,
'
,•
13~

II
R
-
~
3

E .' \" • 2-
....
~
•••••
'. '
-E
" 0
0 7

.-" , '. Ag. 2.22: The dcI.'Clopmcn t of


'.
indr.idual follicles in a heifer

" \7 19 21 0 1 3 S 7 9 11 13 15 17 0 I 2 1 4
, wi th two fonicu lar wa\"CS duro
ing the estrous l)'CIc (adapted
from SIROIS and FORTUNE
Days after ovul ation 1988).

3 follicular waves per estrous cycle


\7 Ovulation
~

-.-- \,
0
U
+ Ovulation
-.£ \, +
~

· ... ... . . ..
•·
0 r---"
~ II ,
E I
" •

~

E
./
,•
-E ,
0
0
" 7

~
Fig. 2.23: 'The development of
.- ~
~ individual follicles in a hcircr

" , 19 0 1 3 S 7 9 II 13 IS 17 19 0 J 2 3
with th ree follicular waves dur-
ing the cst rou.~ l)'C1c (adapted
17 .j from SIROIS and FORTUI"E
Days after ovulation 1988).

Avto ozasc c1Ogradivo


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Poifides 93

2.2.1.2 Follicular development during the lar wavc stans and another dominant follicle dC'o·elops.
estrus cycle and in early pregnancy In the case of a 2-phasc follkular cycle this onc will ter·
minate in ovultltion (Fig. 2.22). Some C:ltlle show tI
Follicles grow on the ovaries :It regular intervals of 2-phasc, others a 3-phase pilttern of d<....'CIopment (IRE,
several dnys. The development of the largest follicle in LAND 1987, SIROIS lind FORTUNE 1988. GIN111ER et 011.
each case is usually inversely correlated to the diameter 1989 a). A follicul:.r growth pattern where 4 dominant
of the second largcst follicle and to the number of all follicles develop in succession during a single cycle is a
Olher follicles (Fig. 2.21). During the first 3 days after rarity. In 3·phasc follicular development the second
an ovulation the largest follicle on a pair of ovaries dominant follicle also regrCSSN. and a third follicle
usually only has a medium diameter of 5 to 8 mm. After develops into the estrous follicle (Fig. 2.23). The time
thnt it develops rather rapidly to rench it.. maximum di· intervnl between the onsel of gTO\\1h of suctCMive
ameter of 12 to 14 mm berwcen Days 7 and 10 and then dominant follicles seems similar in 2- and 3·phasic
becomes smaller again. While the dominant follicle cycles, namely 7 to 10 days (GIl'mIER ct aL 1989 a). The
grows, the second one becomes smaller, and visa versa. total length of estrou.~ cycles with 3 follicular waves is.
Also the number of the smaller, sonogrnphically visible on a\·enlge. 2 to 3 days longer. A third wnve of follicles
vesicles is inversely correlated to the development of the L.. most commonly observed in heifers having .. 2 to 3
dominant follicle. The highest numbers of small follicles day delay in the regrc......ion of their corpus luteum.
are found during the days following an ovulation, i.e. in During the first few ....-ceks of pregnancy this hasic
metestru5 (MAlTON et al. 1981. PtERSON and Gll"'fH.ER pattern of follicular gTO\\1h, with its contrasts in the de·
1984 b, KAliN 1989 c). When a diestrous follicle begins velopment betwccn the dominant follicle on the one
to dcveklp thereafter. the number of smaller follicles hand and the second largest follicle and the remainder
rnpidly declines. This rontrasting pattern of the devel· of follicles on the other. persists (SoINEEBEU 1984.
opment of dominant and remaining follicles W'olS found PIERSON and GIN11 IER 1986). This wave-like succession
in cyclic as well a... early pregnant heifers (PIERSON and of dominunt follicles at intervals of 9 to 10 days can be
GINTHER 1984 band 1986). obscn-cd during the first two months of gc...tation
The growth nile of the largest follicle from the time (GIN11IER el al. 1989 b).
it becomc... dominant until the day it reaches its maxi· Except for the days during metc...trus. there is usu-
mum diameter is, on average, 1.5 10 2.5 mm per day ally a vesicle with a diameter of 10 or more millimeters
(DRIANOOURT et al. 1988). This growth rate is the same prescnt on one of the ovaries C\-cry day of the estrous
for dominant follicles during the luteal phase, for cst· cyde (CtIOUDARY et al. 1968, IRELAND et al. 1979,
rous follicles during the last few days before ovulation SrAIGMILLER and ENGlAND 1981). Most follicles have a
and for those follicles that develop after induced super· diametcr of Ics... than 14 mm during met-, di- and pro--
ovulation. estrus. In a few cases. ho\.\'cver, follicles with a diameter
Follicular growth in cattle occurs in wavc like pat- of 14 to 20 mm can be detected during diestrus or the
terns. At the time of ovulation another vc...icle i... grow· first few weeks of pregnancy at the same time, the
ing to develop into the dominant follicle, to grow diametcr of some estrous follicles can be smaller thun
further during metestru5 and to reach its maximum 14 mm. It C'.ln be concluded that in vcterinary practice
diameter during the early luteal phase between Days 4 the diameterof a follicle alone cannot be relied on to in·
and 10 of thc cycle. Shonly after this dicstrous follicle diC'.lte the sttlgc of Ihe reproductivc cycle of n row.
has reached its maximum diameter, the second follico-

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94 Ultrasonogrtl/HI), in the cow

Animals Estrous folli- Dial!leter of estrous follicles (mm)


studied cles studied d, smallest largest
12 heifers
54 14.7 ±2.6 12.0 20.0
in 51 cycles
f.¥tg. 2.24: The internal diamClCrs of ~Irous
45 cows
45 15. 3± 2.9 10.0 20.0 follicles in heifers and COY>"S prior 10 AI (from
before AI KA" s 1989 c).

I-lg. 2.25: Q\'llrywith a ma ture. compact corpus lutcum. Com- FIg. 2.26: Cross section through the solid corpus loteom ana-
pared 10 lhe surrounding (Mlrian pareoch)ma Ihe t"Orpus lu- logous 10 the sectional plane in Fig. 2.25.
tcum (al1'OW!i) is less echoic. UJ/rnsooogram t3kcn in 3 wate r
b3th .

•lg. 2.21: Corpus lu teum (al1'OW!i) wilh o.:nlral ClIvity. The FIg. 2.28: Cross section th rough Ihe COrpu... luleum "ilh ClI\icy
t'(:hoic lU1cll1 WIlli of Sr.."Vcrnl millimeters th iclo:nC!ioS surrounds analogous to the !iCClional plane in Fig. 2.27.
thc anechoic cavity. Ultrasonogram taken in waler bath.

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COI]HJm IlIlea 95

2.2.1.3 Estrous follicles The sonogrnphic section of luteal tissue appears as a


roughly granular. gray-structured oval area on the
The avcr.lge diameter of the cavity of the estrous fol- monitor (Fig. 2.25 to 2.28). It can be delineated from
liclc at the time of standing heal is 15 mm (PIERSON and thc remaining ovarian t~ue orother functional Slruetu-
GIIfflIER 1984 b, KAHN and UIDL 1986). When its wall res that may be on the ovary. The relatively hypoecho-
I is included Ihis means that a preovulatory follicle has a genidty of thc aetr.'C corpus luteum is in distinct con-
total size of 18 mm (QUIRK et al. 1986). The range of trast to the brighter gray of the ovarian parenchyma.
the inner diameter of estrous follicles on the day of The Jalter usually contains SC\'Cml \'CSicular Slrueturcs
I standing estrus is JO to 20 mm (Fig. 2.24). It is note- of v"dI)'ing sizes. whereas the lutcal tissue contains no
....'Orthy that pregnancies can result from large follicles of fluid. except in the case where it oo'Cloped a cavity dur-
I 20 mm as well as from small follicles of 10 mm. ing its devc1opmcnl. The ....'Cak cchogcnicity of lutcal tis-
The daily increase in the size of the estrous follicle sue corresponds to reflections typically produced by

I during the days preceding ovulation is 1.5 to 2.5 mm.


Most estrous follicles that have been studied by ultrn.so-
nography rcuched their maximum size on thc penulti-
loose, less dcnse. highly vascular soft tissues. The highcr
echogcnicity of thc ovarian stroma. in contrast. reflects
its solid cons.istcncy and higher tis... uc density.
mate duy before ovulation and did not grow largcr dur- Corpora lutca with cavitic.... so called cystic corpora
ing the 36 hours prior to ovulation. lutea. can also be diagnosed by ultrasonogmphy (PIEH--
SON and G II\"f1!ER 1984 b, REEVES et III. 1984, KAHN
and UIDL 1986. Krro ct al. 1986). In a corpus lutcum
2.2.2 Corpora lutea with a cavity an echoic rim of tissue, a few millimeters
thick, surrounds a central. anechoic fluid accumulation
2.2.2. 1 Sonographic image of corpora lutea (Fig. 2.27). The ecOOgenicity of the rim of tissue is the
Corpora lutca are rcrognizcd by their size and shape same as that of luteal tissue and thus corresponds to
I as well as their charactcristic cchographic appearance that of solid corpora lulea.
(PIERSON and GINTHER 1984 b. KAHN and 1EI0L 1986).

I
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96 U/tnlsoflogrophy ill tile CD II'

Fig. 2.29: A solid corpus Ju teunI or the C)'tk (size: 28.5 " 18 FIg. 2.JO: A corpus lulcum of [he cycle (arroo'S) 3 day.; afler
mOl) wilh a hyperc<:hoic. centrnl line. Ultrn5000grnm laken O\'Ulmion. I l~ size is. 19)( 16 0101. At ils center there is a cavity
wilh a 7.5 MHzlincarscunnc r. or 6.5 0101 and to its left is a follicle of about 8 01m.

Fig. 2031: A mmpacl corpus ]ulcum on Day 9 or Ihe cycle. Fig. 2032: Regl'CS.'iing corpus lulcum (arrows) one day before
Length: 29 mOl. widlh: 23.5 mm. Ihe nC)(1 t'SIf\l$; lenglh : 19.5 0101. wid th: 15.5 0101. A~ the
corpus lutcum arc N'O procstrous follicles (diamcter about 14
mm).

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Corpora Imeo 97

Frequently, the cross section of a corpus lutcum con- 18 and 21 mm when they first hcrome detectable on
tains a narrow, hyperechoic zone in its center (Fig. 2.29 the third day arter ovulation (PIERSON and Gtl'mlER
and 2.33). This site corresponds to a similar onc that 1984 b, KAliN 1986).
can be identified on the sectioned corpus luteum . It They then grow I mm in width and 2 mm in length
consists of branching connective tissue which, starting per day, and reach their maximum size of about 20" 30
from the center, compartmentalizes the wavy, densely mm by Day 8 to 10 post ovulation (Fig. 2.31). After lu-
packcd layers of luteinized tissuc. A hypcrcchoic central tcolysis has begun or PGF2a has been injected the
zonc can always be seen aftcr thc closure of a central largest diameter of the corpus luteum rapidly falls to be-
cavity in a corpus luteum. This pattcrn can be found in I()\.V 23 mm (QUIRK et at 1986). At a frequency of
corpora lutca of thc cycle as well as those of pregnancy. 5 MHz, corpora lutea are reliably detectable from their
Immediately following ovulation the developing lu· early development to the end of diestrus, and nearly all
teal tissue cannot yet be recognized. The young corpus of them arc still identifiable aI the time of next
lutcum only becomes sonographically detectable 2 to 4 ovulation (Fig. 2.32). In some c 1ses they C"".ln still be
days post-ovulation (Fig. 2.30). Corpora lutea have a identifiable as corpora albicans for several days after the
mean width of 14 mm and a mean length of between onset of the next C)oclc.

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98 Ultrnsollogmphy i1l the co"'

t-lg. 2.33: A solid corpus lu[cum of pregnancy (Size: 26 x 195 Fig. 2.34: C)'stic oorpus IUleum (arrtJ\.\'S) on Day 11 of the cy.
mm) ..... il h a hypcn."Choic line in its CClilc r. Day 2 1 of pn:gnun· cle. TIle corpus luteum measures 31 x 20 mrn: the cavity
"I. measures 17 x 105 mm.

t-lg. 1:.35: C}~lic DJrpus lutcum (arrtM'S) on Day 8 of the cycle. Fig. 2.36: Cystic corpus lutcum (UIT(J\o\'S) on Day II of lhe cy.
The cavity lies ccccnlric:llly :and has an irregular outline. cle. 'Ibc diameler of Ihe cavilY is 22 x 19 mm. 1bc eslrous C).
de of the cow "~dS 23 days kmg. Slight rc nl"Ctions can be secn
within [he nuid of the «wity.

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OAlpBJ5 oueW SBZ O)jSJOJflV
Corpom luletl 99

The gray scales of the corpora lutea of different ages lar shape (Fig. 2.35). The largcst diameters of the cavi·
vary very lillie and cannot be employed for diagnostic tic... usually vary from a few millimeters to 1.5 em.
purposes. At the same time, corpora lutea of pregnancy Rarely, they can reach 20 mm or more (Fig. 2.36).
canllOt be distinguished on the basis of thcir cchogenic- The cchogenioty of thc C'.Ivitics is similar to thai of
ity from those of the cycle (Fig. 2.33). The dimensions follicles. Slight reflections C'.In occasionally be seen in·
(length and width) of corpora lutea of pregnancy are side the cavity's fluid (Fig. 2.36).The luteinv-.cd wall is
much the same as those of corpom luteil of the cycle. used to differentiate cystic corpom lutea from ovllrian
The cavities inside corpora lutea are usuaUy oval, oc- follicles. Whereas follicles are seen to lie embedded in
casionally round ilnd nearly alW'.I)'S centmlly positioned the hypcrechoic ovarian parenchyma, the cavity of the
inside the gland (Fig. 2.34). Only in exceptional case." cystic corptt'l luteum is scp<tr.ued from the bright ovari-
are they eccentrically positioned or ha\'C they an irregu· an IL'lSUe by its slightly Ics... echoic w.lII of luteal tissue.

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,
100 UltruSOllogrtlfJlly in ,he COli'

Fig. 2.37: CorpU!i Illleum of pll:gnalK')' with a ccntmJ C"JviIY fig. 2.J8: Uterus (IIrTO\.\'S) "" it h a conceptus (C) on Day 28
(diameter 16 x 10 mm). This corpus IUleum wa.~ found in a IOoith a simultaneously prescnt t)'SIic corpus luleum (sec Fig.
00Y0' on Day 28 of gcsl:llion (sec Fig. 2.38). 2.37).

fig. 2.39: Four non<)~ic torpor.! IUlea ( I. 2, 3 and 4) on a tlg. 2.40: A non<)'Stic and a cysIic corpus IUleum (Jefl) on the
single ovary after superovulation. Their length ranges from 24 0\'ary6daysbcforc the onset orllle next cycle. 111c rorporn lu-
to 25 mm: their width from 1310 J 7 mm. lea arc indicated by arroYo's.

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OAlpEJ5 auaW SEZ O)jSJO\,.,V
Corpom IlIlea 101

As during the estrous cycle, cystic corpora lutea can hypocchoic 1i,<;SUC lines (Fig. 2.39). The bulk of the
also be found during the first weeks of pregnancy (Fig. OVllry then consists of the hypol."Choic echo patterns
2.37 and 2.38). After the third \.\'C ek of pregnancy they which arc typical for luteal lis.<;uc. The size and echo-
lire seen infrequently. The fertility of animal~ with a genicily encountered in multiple corpora lutell is nOi
cystic corpus luteum is the same a~ that of cows with the different from the piclu re observed in single luteal
solid type of corpo... lute um. glands.
With the aid of uJtra.o;onogl".Iphy the number of cor· When mUltiple corpora IUlea :Ire present in a cow
porn lutea on ;In ovary can be dctennined quite accu· they can be of both. the compaet llnd the cystic type....
r,lIcly (DRIANCOUKT et al. 1988). In thi... manner the (Fig. 2.40). Cases can be found in which only solid cor·
success of a superovulation attempt C'J" Il be t1sscsscd and porn IUlea arc present allhe same lime ; sometimes the
the number of embryos that could possibly be harvcsted comp:let and cystic fo mlS occur in adjacent corpora
can be l.'Stimated. Where se\'C ral corpora IUlea lie dose· Julea and in other animals only the CYSlic fomls can be
Iy together they arc u... ually only separated by thin, visualized.

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102 Ultrasonography in lite COW

100
Estrous cycle D '" C. I. with cavity ~ mm
'"
80 D = C. I. with cavi ty ~7 mm
70
60
%'"
40
30
20
10 t1g. 2.41 : The: percentage of corpora
o lutea with a cavity (~3 mm or
3 4 5 6 7 8 9 10 I I 12 13 14 15 16 17 18 19 20 21 <!: 7 mm) during the estrous cycle in
Days after ovulation heifers (from KAHN 1989 a).

100
Early prrgnancy D =C. I. wi th cavity ~ mm
'"
80 = C. I. wi th cavity ~7 mm
70
60
%'"
40
30
20
10 tlg. 2.42: }11c percentage of corpora
o lutea with a cavity (~3 mm o r
4 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 21 ~ 7 mm) during early pregnancy in

Days after ovulation heifers (from KAliN 1989 a).

-0- = C. I. with cavity


'"
12
30
Estro us cycle • = C. J. without cavity

28
26

e"
e "20
"
16

" Fig. 2.43: The! length of oon.cystic and


"r - 3 , , __
10 ., " __, - - , - ,__.,__.,- ,,__' -- ' - '__.'~'r-.' +-"'__.'__+-~-<
• 7 8 9 10 1I 12 13 14 IS t6 17 18 19 20 21
cystic corpor.alutea during the estrous
t)'C1c in heifers (mean % SO; from
Days after ovulation KAliN 1989 a).

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Corport/llllea 103

2.2.2.2 Incidcncc and development or cystic dcnce of the former type should be lower in early preg-
and non-cystic corpora lutea during the est· nant cows. The OOscI'\'Cd ralios do not. howC\'Cr. sup-
rous cycle and in early pregnancy pon this hypothesis. In contmst. in pregnant cows cystic
corpora lutea were found at least as frequently lIS during
In caule corpora lutea with or without a cavity occur the cycle. This indicates that the pregnancy rates in
during the cycle and early pregnancy. The non-cystie cows with the two types of luteal glands are the same
and cystic forms of corpora lutea can be seen as nonnal (Krro et al. 1986).
variations of luteal ghands in caule. Compact and cystic When cystic and non-cystie corpora lutea ....-cre fin;t
corpora lutea occur alternately in cau le. The type of the detected on Day 3 of the cycle they had a mean lengt h
luteal gland had no effect on cycle length, endocrine of 17 mm (Fig. 2.43). Thereafter the increase in the
pattern or fertility in callie (KAliN and LEIDL 1988. length of Ihe two types of corpora lutea differed. with
KAHN 1989 a). the cystic type being longer than the compact type at all
The incidence and the size of IUleal glunds. wilh or timcs. The cystic and compact tYf.K!S reached their maxi-
without .1 cavity, were studied in a lllie during Ihe cycle mum lengt h of28lmd 24.5 mm on Day 8 and Day lOaf
and in the firslthree weeks of pregmmcy. It was shown diestrus. rcspccti\'Cly. They then slowly decreased in
that the C'dvity in cystic CI reachcd its lurgcst diameter size. The length of cystic forms decrea'iCd faster than
between Days 8 and 10 of the cycle (KAI-IN 1986). AI that of compact fomls. From Day 6 10 17 of the cycle
this time cavilies occurred most frequ ently and reached the cystic Os ....-cre consistently 2 to 4 mOl longer than
their largest size. Afterwards they decreased in inci- their compact counterpans.
dence and size with time. The cystic forms of luteal g1and~ were also I to 3 mm
Until Day 10. one third to a half of ull corpora lulea longer than the compact forms from Day 9 until Day 21
in normal cycles contained a sonographically detectable of early geslation (Fig. 2.44). A comparison between lu-
cavity (Fig. 2.41). After this day the incidence of cystic teal glands of the cycle and those of pregnancy revealed
corpora 100ea decreased by 3 to 4 % per day so Ihat that both, compact and cystic corpora lutea were a
fewer than one third of all luteal glands contained cavi· liule longer in pregnancy than during the cycle (KAHN
ties by day 13. 1989 a). By Day 18 of the cycle and early pregnancy the
Non<ySlic and cystic Cl<i could be found with equal sizes of compact corpora lutea varied bet,",,'Cen 22 and
frequency during nonnal cycles and in early pregnancy 24 mOl. and bet....'Ccn 24 and 26 mm. rcspccth'C1y.
(Fig. 2.42). If cows with a cystic corpus luteum ,",,'Cre less
fertile than rows with compact luteal glands, the ina-
I

34
Early preganey
J2

I
JO
28

"
j Ij ~ I ::±__~A
e" I "'f-- -+- I
e ",.
I "
""
- : - : C. I. with cavity
I : C. I. without cavity

fi&. 2..44: The k ngth or OOfl<)'SIic and 12


C)'SIic corpora lu tea during early preg- 10 'I I I I I I • I I I I I I I I I I I I
nancy in heifers (mc:m :t: SO: rrom ;/ 3 4 , 6 7 8 9 10 II 12 13 14 I' 16 17 18 19 20 21
KAt"" 1989 a). Days after ovulation

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104 Ultrasonography in IIII! cow

• = Longitudinal di ameter of cavities

" Estrous cycle • = Transverse diameter of cavities


14

12

\0
§8 d
,
~
• 1 fo-Ig. 2.45: The longitudinal and trans-
\'ersc di:lmetcrs of the cavities in cyst-
I , , , , , , , , , , , , , , , , , , , ic corpom !Ulea during the CSlfOUS
5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 2] cycle in heifers (mean % SO; from
Days after ovulation KAHN 1989 a).

"
14
Early pregnancy •
a
= Longitudinal diameter of cavities
'"' Transverse diameter of cavities
12

10
=
, 8


2
Hg. 2.46: The longitudinal and trans-
,
, ,

7
I
8 9
I I
to II 12 13 14 IS 16 17 18 19 20 2 t
verse diameters o f the cavities in cyst-
ic corpora lutea during early preg-
Days after ovulation nancy in heifers (mean :t SO; from
KAHN 1989 a) .

• = Volume of cavities
9000
Estrous cycle o Luteal tissue of cystic CIs
8000 o :: :IZ

Luteal tissue of non-cystic Cis


7000
,., 6000

§5000
<000
JOOO
2000
1000 rig. 2.47: The \'Olumes of non-cyslic
o and cystic corpora lutca and their
5 6 1 8 9 10 11 12 13 ]4 IS 16 17 18 19 20 21 cavities during the C5trous tyde in
Days after ovulation heifers (mean ; from KAHN 1989 a).

Avklrsko Las~ lane cradi '0


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Co/porn I//Ieo 105

The 10ngilUdinai diameters of the cavities of cyclic luteal tissue bcty..·een the Iwo form.;; vmied from 100010
Os and of Os of pregnancy increased until about Day 3000 mm3 in the period from the 6th 10 Ihe 20th day of
10 post ovulation when they measured approximately diestrus (OKUDA 1982).
II mm (Fig. 2,45 and 2,46). After that the longitudinal A comparison of the de\'Clopment of luteal glands
diameters of the cavities decreased by about 0.5 mm per between those of no rmal diestrous and those of early
day and measured only 5 mm at the lime of Ihe nexl pregnancy shQY,'Cd no signifiC"<tnl differences. Over.llI.
estrus or o n Day 21 of gestation . luteal gland.;; of pregnancy "..e re gener.llIy a little larger
Similar increases and dccn:a scs were recorded for than those of normal diestrus. Similar to the OOscrv..J-
the tranS\'Cf'SC diameters of Ihe cavities of luteal glands tions during the cycle, it was ulso shown that during
of the cycle and of pregnancy. These were, hQY,·cver. early gestation cystic corpora lutea contained more
consistently a few millimeters shorter than those of the luteal tissue than compact ones (Fig. 2.48). Even in
10ngilUdinai diameters. From these observations it is their development of cavities cystic corpora lutea of
clear that the cavities in corpora lutea have a predomi- pregnancy and of nonnal diestrus did nOl differ mark-
nantly oval shape which largcly follows thc outer con- edly. They also grew to a mean size of II mm by Day 8
to urs of the glands. to 10 and then continuo usly became smaller (KnD et al.
Since the cavities can reaeh a considerable size dur- 1986). After Day 30 of gestatio n in cattle it is vel)' rare
ing the first 14 days post ovulalion, it was suspected that to find a corpus luteum with a cavity, The dis..'I ppear-
cystic corpora lutea might contain less luteal tissue than ancc of the cavities can be explained by the increase in
their compact counterparts, and that they may thus thickness of the luteal walls of the Cis (LEtDL et al.
secrete less progesterone. 1983). Very few cystic corpora lutea are found in the
The total volume of cystic and non-cystie luteal fourth .....eek of pregnancy.
glands increased during the estrous cycle from a mean Studies completed thus fa r o n the endocrine status
of 1984 mm 3 and 1329 mm 3 on Ihe third day afler ovu- of cattle with either a cystic o r a solid corpus luteum
lation to a mean of 6000 to 7000 mm J and 4000 mm J • have shown no deficiency in the progesterone secretion
respectively, in the middle of diestrus around Day 8 10 of the luteal glands with cavities (KAHN 1986. Krro et al.
13 of the cycle (Fig. 2,47). At the same time the cavities 1986). The mean plasma progcslerone concentration
within the CIs grcw from a mean of 170 to 400 mm J . Af- O\'cr the entire cycle in cows with a cystic corpus luteunl
ter subtracting the cavity's volume from the total \"01- was maintained at the same IC\'el as that of cov.s with a
ume of Ihe cystie corpus luteum. il became surprisingly compact gland. The adequacy of progesterone secretion
clear thai the cystic glands conlained more luteal lissuc by cystie luteal glands was also dcmonstnttcd by using
than compact glands. The difference in the amount of hCG stimulation .

9000
• = Volume of cavities
Early pregnancy 0 = Luteal tissue of cystic Cis
l1OOO
7000

'"E ""'" ./
ElOOO
4000
3000
2000
1000
Fig. 2.48: 11Ie volumes of non<yslic
and cystic corpora lutca and their o
cavities during early pregnalk.)' in J • , 6 7 8 9 10 II 12 13 14 1.5 16 11 18 19 20 2-;
hci(crs (mean; from KAHN 1989 a). Days after ovulation

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106 U1trrlsollosruphy ill the CDII'

Fig. 2."9: Ovm)' containing three theca-follicular l)'StS. Two t1g. 2.50: Section through the same OV"Jry analogous to tile
C)'Sl~ share a straight dividing wall; o n the righ t a smaller t)'St sectional plane in Fig. 2.49.
bulges into the middle one. Ultmsooognlm taken in a Wllter-
bath.

Fig. 2.5 1: o.~.Iry


containing a lu teinized follicular C)'St (ar- rig. 2.52: Ovary containing a thecal follicula r cyst. lhe diame-
rows). The inner cavity sl}O\Oo'S a network of echoes. The ....-all ter o f the C)'St is about 5 em.
mea.QJrcs several millimeters in thickness.

Ay S ozas 10
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Ch'ana" C)'SLS 107

In some C'.JSCS progesterone secretion of g.'Stic luteal are characterized by large anechoic areas. Thc dark
glands even exceeded the levels found in cows with nuid content of thecal follicular cysts hardly e"er con·
compact corpom lutca. Thc tendency for highe r plasma tains any renections (Fig. 2.52). Thc lumina of lutein·
progesterone levels in CCM'S with cystic iuteni ghmds is ized cysts OCC'dSionally contain a network of echocs (Fig.
likely explaincd by the fact that they have larger 2.5 1).
amounts of IUleallissuc. Among the sonogmphically visible OV'"drian cysts two
In conclusion. the studic.ct completed thus far on thc distinct forms can be recognized. The one fonn hns such
incidence, development and endocrinc function of cyst· a thin wall that its structure cannot be aswsscd (Fig.
ic corpora lutca of the cycle and of pregnancy, with 2.52). Most of Ihese structures are likely 10 be thecal fol·
cavity diamcters ranging from a few millimcters to licular cysts. The second kind are ovarian cysts wilh a
2 centimeters, have no indication that they are endocri· thicker wall. The laller is a few millimeters thick and
nologically dysfunctional. This conclusion is supponed usually hypocchoic (Fig. 2.5 1). ILct cchogenicity is simi·
by the fact thaI the pregnancy rates of cattle with cystic lar to that of luteal tissue. The adjaccnt ovnrian tissue
corpora lutea are not decreased. usually appears mther hypcrechoic in comparison to the
cyst wall. These vesicular structures are likcly to fall in·
to the category of luteinized follicu lar cysts. If thecal
2.2.3 Ovarian cysts and lutcinized follicular cysts appear in their vcI)' char·
acteristic forms, i.c. with eithcr a vel)' thin or a vel)'
In their sonographic appearance ovarian cysts re· thick wnll. respectively. their differentiation should pre·
semble large follicles (Fig. 2.49 and 2.50). One distin· sent little difficully. In the mixed or transitional forms it
guishing feature is their larger size. In the casc of a lu· ....,ould. however be rather more difficult to reliably dig.
teinized follicular cyst its wall thickness can also assist in tinguish between the I""O types on their ultrasonic ap-
its identification. The sectional images of ovarian cysts pearance alone.

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108 U1troSOllognlplly ill file cow

Fq;;. 2.53: Q\rJI)' containing multiple cysts after honnonal Fig. 2.54: Follicular cyst and corpus luteum of the cycle (1Ir-
superovulation tTCa tment of the row. 'Ibe row had rece ived lOWS) on the ovary of a COW 13 dB)'!' after she had been in-
dllily trealmcntsof FSI-I from Days II 107 before and a single jected with GnRI-I (20 g Ouscrelin i.m.) for the Ircalmcnl of
dose o f PG I-"'2a on Day 8 before t h ~ uhrJsonogr.lm was ovari(lO t)'StS. Progesterone W"JS elevated on the day of this
taken. ullrasound examination and the COYo WIDi trcatl-d with PGF2a.
The insemination performed 4 days later resulted in II
pregnancy.

"Ig. 2.55: Follicular cyst in (I row on Day 59 of gcsuu ion (sec •-ig. 2..56: I'regllam utern~ wilh fetus on Day 59 of pregnancy
Fig. 2.56). ill a CfHI with an OYlI rian cyst (sec Fig. 2.55). The fe tal head
(1-1) lies t()\\-:trds the right. the rump t()\\~Jrds the left. and
above the nose there is a front fOOl.

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Omlinll cyrts 109

The shupe of cysts mnges fro m round to oval to p0- cysts can ulsa be found in the presence of an intact preg-
lygonal, sometimes even angular. When they occur as nancy (Fig. 2.55 and 2.56). III single cases O\',.rillll cysts
single structures on an ovary they are usually round. have been detected as laIC as the third month of gesta-
When more than one cyst appeal1; on the same ovary tion.
their shapes are determined by the relative tensions in· A<; a result of their extensive fluid content and their
s.ide adjacent cysts (Fig. 2.53). Their common, scpam- resultant typical sollogr.lphic appcaTuncc ovarian cysts
ting walls are often straight. Cysts with higher inner are easy to diagnose. Thecill follicular cysts are recog-
pressure will bulge into the lumen of cysts with lower nized by their thin, hypcrechoic wOIlis. Luteinized (.)'Sts
pressure. Commonly. sm:.Uer vesicles bulge into lurger can be diagnosed if they are more than 40 mm in
cysts. dill,meler, their walls arc thinner than 5 mm OInd they
Not ull follicular cysts thut c-.m be seen sonogmph- persist unchmlged for a protmctcd period of time. The
ically on ovaries of cows can be considered to have a images of small luteinized cystS with thick walls can
pathological effect. Such cysts have been found during sometimes appcOlr similar to those of large cystic
ultrasound cxaminlltions where iI distinct corpus [utcum corpora lutea (Fig. 2.5 1. 2.57 and 2.58). In the few ClISL'S
of the cycle was present simultaneously (Fig. 2.54). In where a structure with a p..1Tticularly large inner cavity
such cases the corpus luteum is usually the structure and a relatively thick wall are found it may not be
that determines cyclic events. which can be normal wit h possible to differentiate reliably between 01 cystic corpus
pregnancies resulting from an im'Olved estrus. Ovllrian luteum ilnd a luteinized follicular cyst.

Ag. 2.S7 : Cystic corpusluteum (am,",s) with a ''Cry large cav· Fig. 2.58: Largc CYSlic corpus IUlcum (bcl\\'Cen thc C'I'OMCS) 8
ity 14 days after ovulation. The next estrus of this cow oc- days after O\'Ulation.llIC co'l'us lutcum measures 36 x 27 111m
curred at the nomlal time. Mild I'l;'ncctions arc visible inside and its C'o.lyity I ) x 9 mm.
the lumen of the corpus luteum.

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11 0 Ultrasonography ill 'he cow

.".2.59: Oval}' with :1granulosa cell tu mor (arrO\\'5). Duri ng F". 2.60: Cross Sl.'Ction th rough the sallie ovarinn tumor mUI·
[he 11l.\t 3 ....~ks prior to ovariectomy. the row hlld a plasma logous to the examination plane as in Fig. 2.59.
progesterone concentrat ion or ( 1.0 nglml. 1llcrc arc nUlllcr·
ous hn ...... choic CI'O!i."i .scaions through blood ~Is in the
dorsal pan o rthc tumor. 1bc \'Cntral pan orthc tumor shIJ.,.,'S
the L'Chogcnicity typical or solid t~ .

Av 0
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Ol'Uriflll lumor.r I II

2.2.4 Ovarian tumor> Both ovaries ....'CTC rell)()'\'ed by ovariectomy. On


pathological examination the left ovary WdS diagnosed
Ov-.u ian tumors are rare in a utle. The case de- to contain a socccr·b.111-sizcd granulosa cell tumor with
scribed here concerned a three and half year old row. a few :area... of hypcrvascularity. The right oviary also hlld
Nothing conspicuous was nOliced about the row during Changes consistent with a granulosa cell tumor.
the fi rst 1....'0 months post partum. Once the cow showed The described ult ra.o;onic picture of a granulosa cell
estrus she was to be inseminated. Whcn Ihi5 WdS tried a tumor is not ncC(..~ ri ty typical of this t)'pC of ovarian tu·
structure twice as large as a ehild's head was palpatcd in mors in canle, In thi5 single C<tsC the tumor was very
the area of the k ft ovary. The right ovary was also en- compact and its echoic sectional image was only inter-
larged. During an observation period of another 3 rupted by hypocchoic lumina of blood vessels. Other
....'Ccks the cow developed signs of nymphomania and re- case<.; of granulosa cell tumors have been described a...
pe.ned plasma hormone determinations rcvealcd pm- being more polycystic (Andresen et al. 1986). This type:
gesterone concentrations of less than 1.0 nglm!. of granulas.1 cell tumor should then result in a sonogra·
The sonographk image of the tumor contained !'A'O phic image which is more commonty seen in cascsofthe
distinct regions (Fig. 2.59). Hypoc..'Choic trarID'Crse sec- same tumor in horses (WHITE and AIJ.EN 1985. KAl iN
tions through numerous vessels we re seen in the dorsal and U'1I)1. 1987). These ofte n ha\'C a strong capsule of
section of the tumor. The remainde r of the tumor oon- connective tissue underneath which lies a labyrinth con·
tained a coarsely granular echogenicity. producing an taining numerous cystic structures (sec chaptcr 1.2.5).
image of mixed tissuc which was trdvcrsed by numerous The contents of the cysts may be serous or hcmorrhagic
cros:~ sections of smaller \'CMCls. The adjacent areas of and therefore generate an anechoic or moderately
brighter and Ics.<i bright echoes reJ1cded the compact cchoic image on ult rasound examination.
nature of the tumor intcrspersed with islets of .......tX}' tis-
sue (Fig. 2.60). The outline of the tumor could be St..'Cn
and measured.

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112 Ullrosollogroplly ill IIIl' cow

.'ig. 2.6 1: 5.1ginal section through the non-pregnant uterus of Fig, 2,62: Sagillal '>t.'Clion through :I uterus during estru.~. T\\'o
a aM' in diestrus. The large arrtJ\lo'S indicate the grt::lter cul'va- scp.1mte sections of the same uterine hom mn be rerognil.cd,
ture. the ~mall arrow'S the lesser rurvalUre. Auid Ilccumulations arc \'isiblc inside the uterine lumen. Ar·
rtJ\Io'<\ demarcate the outer \\'all of the uterus. Uhl'll'iOnogmm
W31. produced with a 5CCIor scanne r at 5 MI tz.

I'1g. 2.63: Schcmatic presentation of an ultmsound examina· .1g. 2,~: TmllS\'CTSC scctionthmugh the uteru.~ on the day uf-
tion of thc uteru. in trJlb-"·Cr..c din.'Clion w.ing a ~or scun- ter ovul:lIion, TIle tr.Hlwersc SI..'<.1ions through the lefl dorsal
ncr. The .;;.amc .;cuming pl'lllc ~ in Fig. 2.6-1. (Id) and right duMI (rei) ~rt, of the hom~ are on lop, wilh
the cross ~ions through the left n:ntml (Iv) and right vcntrul
(rv) pouts of the horus I:..eolily alld below the dorsal 'i(.'ClON.

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UlI!ntS 11 3

2.3 Uterine structures in the cow in the case of a pregnant uterus. its wall and the em-
bryonic vcsicle in its lumen will be sectioned III various
2.3.1 Non-pregnant uterus levels. Only very rarely is it possible to depict the whole
length of an embl)'Onic vesicle (see chapter 2.3.2.5).
When a linear ultrasound probe is positioned dorsal- When using a suit.. ble sector sc..nner, its grcuter
ly above the uterus and the sound beam is directed maneuverability inside the rectum permils the operntor
dor.;o-ventrd.lly. a longitudinal section of the organ is 00. to project a greater variety of sections through the uter-
tained (Fig. 2.61). Rotating the probe slightly to the left us (Fig. 2.63 and 2.64). The fan shaped ultmsound
and right brings the uterus with its horns into view. Its plane can be rotated from the longitudinal axis of the
outline with the lnrger uterine curvature becomes clear- animal. through "'Mious steps all the way 10 a perfectly
ly visible. The latter is a distinct narrow, hypocchoic line transvel1iC position. In this manne r il is possible. with
which separates the uterine wall from the usually some- the sound W.l\'CS directed dorsoventrally and transverse-
what more echoic surrounding tissue. The lesser curva- ly to the animal, to project a cross section through the
ture - the mesometrial edge of the uterus - is usually less uterus. In this plane of examination, a lotal of 4 trans-
obvious with a variable intensity. When the uterine tone verse sections through the left and right uterine horns
is high. such a.~ in /,:strus. it has, as with the larger curva- can be depicted simultancoLL..ly. These include 2 sec-
ture. a U-shaped, arched appearance. The dorsal and tions through the dorsal part~ of the uterine homs and
ventml sections of the same hom arc at other times of- latemlly below them 2 cros... sections of the vcntral parts
ten so close to one another that they are separated by of the uterine horns.
only a single. hypercchoic line, or diverge at a very acute Wilh the probe guided appropriately along a suitable
angle. path. the winding of the utcrine horns from medial to
The entire length of the spiraling uterine hom codn lateml com be followed. Doing this create... the impres-
usually only be depicted in a single image if the uterus is sion that the tips of the uterine horns curl more dorso-
optimally positioned and the probe is directed al an caudally during the luteal phase than during the days
acute angle in relation 10 the longitudinal axis of the jLL<;t before and just after cstruS'(PtERSON and GINmEIl.
cow. In addition, the ultmsound beam must be rotated 1987). During the pcriovulatory period the hom ends
slighlly from dorsoventml to dorsolateml. In the major- are directed more horizontally in the c:ludolateml di-
ity of C;ISl:S it is impossible to depict the entire curvature rect ion without rolling up in the dorsal directk>n. The
of a hom in a single image. Instead, by vinue of its cur- lesse r culVdture describes a larger radio.<; during this
vature. the ulerus can be sectioned at several places lime thom during dicstrus. The spimling shape of the
(Fig. 2.62), Using a linear scanner, bet\\,'Cen two and uterus is therefor most pronounced during the phase of
four sections through Ihe uterine hom can often be elevated progesterone conccntrations.
visualized in a single image (fAVERNE et al. 1985). Also

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114 UllrrlSQllogrtlpbY ;1I life cow

Fig. 2.65: Uterus of a fX1N during estrus. In thc '·cntnll pan of Fig. 2.66: Uterus of 0 fX1N during diestrus 8 da)'S post O\--ula-
the. hom the hyper,. choic line representing the appositioncd tion. In the ve nt ral SCCIor of the. hom a fluid accumulation can
surfaces of the endome trium (E). Large arrows indicate the. be rccogni7.cd (small arrow). Large arrows dermrcalc the
grea ter curv.llure. small arrOYo'S the lesse r curvature. greate r curvature.

~1g. 2.67: Sagittal section th rough 0 uterus during estrus. .'\g. 2.68: Sagitlol SCCIion through a uterine hom during
There is a few millimeter thick. hypocchoic area. representing estrus. A prominent accumulation of secretions is present in
estrous SI.."CfCtions (5). in the ,·e.n tra] pan o f thc hom. Arrows the tip of the hom (arrOYo'S ).
demarclte the greater CUlv.lture.

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Utems 115

The section through the uterine w;all contains gr,mu- stage of the cycle. smaller, thread like C'Jvilies:L few mil-
lar. variably structured shades of cchogcnieity. In the limeters thick can be found in the uterine lumen (Fig.
center of the organ the <lppositioned surfaces of the lu- 2.66 10 2.68). These are usually seen during estrus, but
minal epithelium often produce a hypcrechoic line (Fig. can also occur during diestrus. They are free of echoes
2.65). This runs along the middle of the uterine section, and can be seen in various of uterine sections (PIERSON
from the tip of the horns up to and through the cervix, and GIi"fTllER 1984 a). During estrus the amount of :ac-
Large, coherent and anechoic fluid acrumulations are cumulated secrelions in the uterine lumen varies con-
not nonnally seen during diestrus. Depending on the siderablyand may reach several centimeters (Fig. 2.68).

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116 UltrtlSOllogrtlIJII), ill/he CDII'

tlg. 2.69: ~mplc of mca~uring Ihe dorsal. "mnial and \"Cn· t1g. 2.72: Ewmplc of an heterogenous ulerine wotll. Apan
Iml diamc' ers of :1 ulerine hom from 'he 'hin fluid accumulmions there are arc:iS of greale r
and lesser I.:ehogenidty in the uterine wa ll. Arrows demarcate
the greater curvature.

" mm

ventrnl 0

cranial 0

dorsal 0

Fig. 2.70: Mean ooThaJ, cnmial and


15,('-.,~e-+--+~e-+--+-;__+--+-;__+--+-;,__.,__,.-~-+ .-~-< __ \'C nt rotJ diameters of non-pregna nt
ot 2 J 4 S 6 7 8 9 10 II t2 13 14 15 16 11 III .9 20 uterine horns during tbe estrous
cycle in heifers_
Days after ovulation

'00
90
80

.,
70 2J)
" l
%'" ., " "- .l

30 " 1. " .J. ~ ~

,.
'" " 17 12.l. ...L ...L 10
S 8 14 Jl...ll Jl. ..ll
Fig. 2.7 1: The percentage or cows
in which a sonogrnphiGally delect-
••, , , 2 4 6 7
10 10119
B 9 10 II 12 Il 14 U 16 17 18 19 20
able fluid !lcrumul:ilion could be
found during .he estrous cycle_
Tage nach Ovulation

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Utents 117

Sc"eml invcstigation.<; were conducted to test cumulations measuring 30 to 40 mOl in length :md 5 to
whether any correlations between the stage of the cow's 10 mm in width can occur.
cycle and the ultrasonic image of her uterus existed. For The fact that fl uid Cdn also be found in the non·preg-
this purpose the diameter of the uterine homs, intra- nant uterus is of considemble importance for the sona--
uterine fluid accumulations and the sonogrdphic ap- gmphic diagnosis of early pregnancy. Since secretions
pearance of the uterine wall were determined in a total can be present in the uterus at any stage of the entire
of 51 estrous cycles of 12 heifen;. estrous C}'Cle, even if no conception has taken place, the
The thickness of the uterine homs could be moni· mere detection of a fluid accumulation should not be in-
tored by measuring the changes in the dorsal, cranial terprded as a reli:lble sign of pregnancy. Pregnancy can
and ventrJ.1 diameters of the uterine horns (Fig. 2.69). only be diagnosed when embryonic components can be
All three diameters were largcst at the time of cstrus identified with certainty.
(Fig. 2.70). They decreased significantly during met- Particularly during proestrus, estrus and metestrus a
estrus until the beginning of diestrus. The uterine layering of the uterine wall into a hypocchoic, adluminal
hams then became thicker again to reach their widest zone :lnd a more echoic peripheml zone is recognizable
diestrous diameter during the middle of cycle, between (Fig. 2.72). During this period one third to 11 half of all
Days 9 and 14. On, or about Day 16 a substantial cows have a heterogeneously structured uterine wall. In
decrease in the uterine hom diameters occurred. The about one half of those cows in which the structure of
the uterine wall was e:tamined ultrasonically during nor-
I thickness of the homs increased again until the next
estrus. o.'cmll, a cycle dependent change in the thick· mal estrous cycles, a heterogenous structuring of the
ness of the uterine horns could be dcmonstmted (Vou..- uterine wall could be recognized on the day of estrus. In
MERIIAUS 1957. PIERSON and GII'mIER 1987). Through· the other half of the cows the ute rine wall appeared to
out the cycle their thickest portion was the ventral, Ix! homogeneously structured. During metestrus be-
cuNed sectlon of the hom. At the cranial and dorsal tween 28 and 53 % of the cows slill had heterogenous
measuring sites the diameters \.\'Cre approximately I to uterine walls. Laminated uterine walls could only be
4 mOl thinner. secn in a few cows during diestrus but in the majority of
In a large proportion of cows fluid accumulations are cases the uterine wall was homogeneously structured.
sonogmphically visible in the uterus at the time of estrus During the days preceding the following estrus the per-
(PIERSON and GIl'I{TliER 1984 a). They are detected in ce ntage of heterogeneously structured uterine walls in-
about half the heifers on the day of estrus and in about creased again to reach 50 % .
one third of the heifers during the few days just prior or As a result of the edema of its more superficialla)'Crs
after estrus (Fig. 2.71). It is interesting that fluid accu- and the accumulation of secretions, the inner areas of
mulations can also occasionally be demonstrated during the uterine wall will become less echoic during the es-
the early and mid luteal phase. The most frequent site trogen dominated stagc.<; of the estrous cycle. This leads
of the flu id accumulation lies just distal to the larger to the layered image of the uterine wall. This seems to
cuNature of the uterine hom in the part that winds cau- be a similar phenomenon to that observed in estrous
dolatemlly. Fairly freq uently, however, hypocchoic mares where the edematous endometrium is distinct
areas can also be found in other pans of the uterus. The from the more dense tissue of the myometrium
size of the fluid accumulations can vary markedly in (GINHIER and PIERSON 1984. KAliN and LEIDL 1985).
non·pregnant uteri. During estrus and diestrus flu id ae-

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11 8 U1fmSOllogropirY ;1I file COli'

I
I

. . . .. .... . .. . .. . ~

Jo1g. 2.73: Embryonic \'CSidc with embryo (E) from il cow on 1-1g. Z. 74: Uterus on Day 12 of pregnancy. H),poechoic sec-
Day 26 of gestation (rell1O\'Cd from the uterine lumen). The tions (small allU\\'S) through the embl)'{mic \'CSic1c are \'isibJc
al1antochorionic vesicle stretches thread like from the tip of in several places. The outline of the ule rine horn is demar-
one uterine hom to the other. In the pregmull hom the in- ru ted by Ihe larger 31"fO\\.'S. Ultrasonogram produced with So..'C-
crca<;e in embryonic nuid leads to an enlargement in the t r.m~ l or scmncr al 5 MHl.
\'e1Se diameter of the vesicle.

I-lg. 2.7S: Bovine uterus on Day 12 of pregn:ml)'. A Uypo-


echoic section (large arrow) Ihrough Ihe embryonic \'csicle is
... iliible in Ihc \·cntr.d pan orthe uterine hom. The greater and
lesser CUr"l~Jlurcs are dcmllll.' lIed by small allU\\'S. Ullr,isono-
gmm produces ...~ I h sector scmncr :ll 5 MI'b~

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l'regnQncy 119

2.3.2 Pregnant uterus 10 until Day 18, only its length incrc:ISCS. Betwecn Days
17 and 20 of gestation, sometimes even earlier, hypo-
From Day 15 of pregnancy the embryo nic vesicle of t.'C hoic sections through the embl)'Onic \lCs.icle are vis-
the bovine will be a thin, thread like tube in the uterine ible in various sectors of the pregnant hom of the utero
lumen (BEI IERIDGE et al. 1980). By Day 20 it will us. In most !';1St'S these minute fluid accumulations are
stretch from the tip of one uterine hom to the other and sections through the chorionic vesicle. At this stnge it
have a total length of up to I meter (WINTERS et al. lies thread like in thc uterine lumen :md contains vcry
1942, OlAFFAUX et al. 1982). Until Day 25 the cross little flu id (GREEN~TE1N nnd FOLEY 1958). Around day
sectional diameter of the allantochorionic and amniotic 19 the embryonic vesicle will fonn a slight distention
~icle is still so small that a fluid filled embryonic usually near the middle of the pregnant hom, in the
~icle can only be detected by using higher frequency same aren where the fluid first became visible.
ultrasonogmphy of 5 MHz or more (KMIN 1985). From Sonogrdphic imaging of the embryonj(; vesicle at this
around Day 25 the amount of fluid in the allantocho- early stage is difficult and thus unreliable. For example
rionic vesicle increases mpidly so that aL..a the embryo experience was made that a nuid fill ed vcsicle could be
onic \lCsicle's transverse diameter becomes considerably detected in some oows betv.'(;en Days II and 13. but not
gremer (Fig. 2.73). between Days 14 and 17, although the cows ,"lere later
found to be pregnant. The maximum diameter of the
fluid accumulmion in early prcgnancy before Day 20
2.3.2. 1 Day 10 to 20 of pregnancy reaches not more than 2 to 3 mm (BI,I IERIDGE et al.
1980). The largest diameter of the embryonic vesicle
If cows ilre examined sonographically every dny after therefore lics at the lower limit of resolution a(;hicvcd
insemination a minute flu id accumulation may become even by high performance ultrasound equipment. While
apparent between Days 10 and 17 of the cycle (Fig. 2.74 it seems feasible that uitmsonDgmphy can be applied
and 2.75). The fluid will lie in the hom ipsilateml to the successfully for research pul")XtSCs 10 sludy early preg·
corpus luteum (CURRANet al. 1986 a). It will appear as nancy, it is not possible to usc ultTllSOnography as a tool
thin, anechoic areas that are round in shape in three for the reliable pregnancy diagnosis before Day 20
quarters of all cows and measure 2 to 4 mm in size (KASTEUC et al. 1989). From a differential diagnostic
(PIERSON :md GINll/ER 1984 a). In approximately one point of view the hypoechoic fluid accumulat ions can·
third of the pregnant cows they will be elongated and not be distinguished reliably from similar images seen
are 2 mm thick and 3to 7 mm long. The diameter of the during estrus, diestrus or in certain pathological condi·
embryonic vesicle i1PPCilrs to remain constant from Day tions.

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120 U/trnsollogrnpll)' ill the cow

FIg. 2.76: Uterus on Day 21 o f pregnancy. The hypocchoic Fig. 2.77: Uterus on Day 22 of pregnancy. 1bc larg~1 fluid
area of the embryonic \'i;side (V) has a size o f 9.5 ..: 4 111m. collection inside the embl)"Onic vcsicle (V) is located in the
Ultr.lsonogmm produced wi th a st"CIor scanner ;11 5 MHz. \'i; nt ral portion of the uterine hom. Arrows dcm31"C3te the
grc3le r CUIY.llUre.

fig. 2.78: Uterus on Day 23 of pregnancy. The embl)'O (E) lies rig.2.79: Uterus on O:lY 24 of pregnancy. 'r1lc :lllllntoic memo
at the I1oor o fthe vesicle. During real time scanning pulsation brane (arrow) floats inside the embl)"Onic vcsicle.
W'.IS de tectable in the area of the dc\'i;loping hean. Ultrasono-
gram produa..--d with Sl..'CIor scanner al 5 MHz.

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IWgnallc)' 121

2.3.2.2 Day 2 1 to 24 of pregnancy on Day 30 (Fig. 2.80). In the bovine. the all,mtoic vcs-
icle undergoes paniculurly ntpid growth in length
Between Days 21 lind 24 of gcstation the :Imount of :u'Ound the 23rd day of pregnancy ( SAIJSBURY et al.
fluid inside the cmbl)'Onic \'(."Sicle hns usually increased 1978). By Day 32 to 37 the allantois will line the cntire
to such an CJC\em that it becomes easier to visulilize by or
inner surface the chorion.
ultr.:oonogmphy (Fig. 2.76). At the Site of its greatcst During this ea rl ie.~t phase of the sonogntphic preg-
expansion, usually in the .. rca of the amnion, the em- nancy diagnosis particular attention must be paid to
bryonic vesicle reaches .. diameter of between 3 and 5 confirm that the obscn'cd fl uid accumuhltion is intrd-
mm and a length of .. bout I em on Day 22 of gestation uterinc. There is nlW'd)'s the pitf:tll of confusing the
(KAliN 1985). The largest flu id accumulation is most blood vessels that run on the surface of the uterus with
frequently seen for the first lime distal to the cutvature nuid accumulations within the uterine lumen (T AVERNE
of the uterine hom, in its free, winding section (Fig. et nl. 1985). Finding the conceptus with certainty lit this
2.77). This is also the site where the embryo .. nd its sur- stage requires a thorough sonographic ex.amination of
rounding amnion become delectable for the first time. the uteru.s. To establish an nccumle diagnosis can some-
Before Day 25 of pregnancy it can often be difficult times take SC\'Cral minutes.
\0 fi nd the embryo itself. Sometime.'i its presence can be
suspcc1ed, but it is difflCUlt to differentiate it fro m other
echoic structura;. Rat her frequemly, though. it can be
identified without doubt (Fig. 2.78). The lcngth of the
embryo between D..ys 21 and 24 is about 5 mm (CuR-
RAN' et al. 1986 a). Occasionally it is even possible .. tthis
time to see a heart be.. , in the form of flickering echoic
points.
The non-pregnant status of a cow can, under certain
circumstances, be diagnosed around Day 20 to 23 post
insemination. In these C"dSCS one ,,'Ould base the nega-
li"e pregnancy diagnosis on the small size of the corpus
luteum (largest diameter ( 20 mm) and the absence of
fl uid in the uterus (KAsn:u c et al. 1989). A positive
pregnancy diagnosis can only be made with certainty
once an embryo has been idemified.
A thin, hyperechoic and !(}\O,'ards the tip of the hom
bulging membrane can sometimes be seen inside the
embryonic fl uid .. t .. bout this stage of pregnancy (Fig.
2.79). Based on its position and the lime of its appear-
ance it is ..s,<;umed thm it represents the allamois (CuR-
RAN et al. 1986 b). This thin, slightly floating membrane
is only visible for .. few days. According to experiences
m.. de thus f.. r it is most frequently detectable on D..ys
23 to 26 of gcstation. In some C<ISCS it may still be seen
Fig. 2.80: Uterus o n Day 28 of prcgnanc;y. The membrane of
the allantoic \'CSicle bulges towards the tip orlhe uterine horn.
In Ih e area where the sou nd W'J\'\!S impact w rtic"JUy onto the
allantoic membrane an intenSive echo (arrow) bccomc.~ visi·
b<.

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122 Ultrasonography in the cow

Fig. 2.8 1: Embr),onic ,·cside (Y) and embryo (E) on Day 25 of FIg. 2.82: Embryonicves.icle on D3Y 26 of pregn3rK.j'. Twosee·
pregnanl)'. The cmbryonic "esiclc ~ends along the rurvat ure tions through the embryonic \"CSic1e arc vislble. Thq' appear
(arrows) into thc dorsal ponion of the utcrine hom. to be separated by a ponion of the echoic uterine \00'1111.

Fig. 2.113: Nuclear magnetic resonance image of a utcrus on rig. 2.84: Vesicle and embryo (E) on D3Y 29 of pn:g.nancy.
Day 26 of pregnarK.j'. In the pregnant hom three fold~ of the Ponions of the ute rine "'-all which lie in the SCUlnmg pl3ne
uterine Willi protrude into iL~ lumen latcrally (small arrows) and the embryo divide the embryonic vesicle illlO pscudoam·
:lnd one from dorsal to \'cntrol (large arrow). Latcrol lo the pullar sectors (I. 2 and 3). Arro.....s demarcate the outline of
homs arc the In-arics (OY). the uterus.

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Pregnanc), 123

2.3.2.3 Day 25 to 30 of pregnancy beam directed donio\,cntr:tlly with a slight lateral devia·
tion. This produces a sagittal section through the uter·
On Day 2S of pregnancy the embryonic vesicle of the ine hom which is chamcterizcd by the echoic, curved
Ix:Mne reachcs a diameter of 10 mm at the point of its ute rine ""'all surrounding the anechoic embryonic \·cs·
Iargesl expansion. By slight rotations of the ultrasound icle. It is usually nOI possible to position the sonographic
probe the course of the embryonic \'csicle can be fol· plane in such a way that the embryonic vesicle is
JooA'Cd into much fu nher areas of the free segment of simultaneously visible in all parts of the hom. More of·
the pregnant uterine horn at this stage. It also stretches ten. only \'3rious segments of the embryonic vesicle will
through the curvature of the hom into the pan where be depicted (Fig. 2.82 to 2.84). The nuid sac of the em-
the two uterine horns are fused to form the uterine brytmic vcsicle is interru pted in places by folds of the
body (Fig. 2.8 1). Until Day 30 the diameter of the em· uterus which project into the lumen. This creatcs a
bryonic vesicle increases to 18 to 20 mm and is then al· pseudo-ampullar image (KAl iNet al. 1989). These folds
SO visible in the contralateral ho m (CHAFFAUX et al. and their spatial ammgemcnt can be demonstrated \'el)'
1982, OJRRAN et :11. 1986 b). In the contralateral hom well on NMR scan pictures (Fig. 2.83). Typically. 2to 3
is much narrower with a diameter of 4 to 8 mm. anechoic sections thro ugh the chorionic \'csicle are vis-
The course of the pregnant uterine ho m · with its ible on a single ultrdSOund im3ge al Day 25 of gcstalion
dorsal segmelli. the ...enlml bend and the caudally direc· (Fig. 2.82). More sections through the emhl)'Onic ves-
ted )XInion - is best demoll5tnlled if the probe is posi- icle will become visible during the next few days so that
tioned above the uterus with its sound plane oriented 4 to 6 sections can often be seen by Day 30 (Fig. 2.84).
along the longitudinal axis of the cow's body and the

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124 Ultrtlsollography in Ihe CDII'

"li:. Z.H5: VesICle ~nd emhl)lJ (E) on Day 26 of pregnancy. "'g. Z.K6: Vesicle lind emblYo (l!.) on Day 31 of prcgnancy.
' 111: embl)lJ tiC!! aUJaccnt to the uterine wall. lbc cmbl)'O is stllrting to nKM: IlWIlY from lhe ulerine wall.

"'g. 2.87: Comparison ur the ~nogmphic pregnant), dingnosis Fig. l.88: Comparison orthe sonogmphic pregnuncydiagnosis
at 5 ~ I lIz. Vesicle and emblYo (E) on Day 32 ofprcgmtO(}'. lit 3.5 MHz. Vesicle wit h embl)'O (E) 00 Day 32 ofprcgnancy.
The \'CSiclc and the embryo II rc difficult to recognize.

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PregllulICY 125

The use of a high resolution scanner will ensure that starts contracting rhythmically (SAUSIIURY ct al. 1978.
the embryo can be detected in all cases of bovine preg- NOI>EN and DE lAllUNTA 1985 b)
nancy between Days 25 and 30 (PIERSON and GINTHER The earliest time at which pregnancy c:m be diag-
1984 a). The embryo's echogcnicity is a little more in- nosed depends very much on the sound frequency ,lI1d
tense than that of the neighbouring endometrium (Fig. the quality of the scanner used (Fig. 2.87 and 2.88).
2.85 to 2.87). Since the embryo lies very close to the Using a 5 MHz sc:mner it should be possible under
uterine wall for the first month of pregnancy, it may practical conditions to demonstrute the embryonic ves-
prove difficult to find (Fig. 2.85). It projects from the icle with relative ease by Day 25. From this Day the ab-
wall into the anechoic uterine lumen and can be identi- sence of fluid from the uterus indicates with reasonable
fied by the presence of a heart beat. The embryo start~ certainty that the cow is non-pregnant. If. in addition to
to moves away from the wall during the next few days the embryonic fluid . the embryo is visible u positive con-
and by Day 30 it is completely surrounded by fluid (Fig. finnation of pregnancy has been obtained. Under cer-
2.86). To identify the embryo accurately its echo must lain conditions the delection of an allamoic membrane
be examined C'd.rcfully to differentiate it from the reflec- a few days prior 10 the detection of the embryo is pos-
tions of other structures. Especially in the area where sible and may be laken as 1I positive confinnation of
the sound W".avcs impact vertically other structures may pregnancy.
produce very intense echoes. Such areas include the While it is possible with u 5 MHz SCimner under
sites where the allantoic membrane is exposed to veni- field conditions to deliver a reliable pregnancy diagnosis
cally imp'lcting sound wuves which then generate vcry betYlCen Days 25 and 30. this is only possible at a later
bright echoes. More ultrasound is returned from the re- stagc if lowcr frcq ucncy probes are used, due to thcir
flective surface vertically oriented to thc transducer, poorer resolution (TAVERNE et al. 1985. aMFFAUX
thcrcby creating thc impression of a \lcl)' intensely et al. 1986. HANZEN and DELSAUX 1987). With a fre-
echoic structure (HAssLER 1984). quency of 3 to 3.5 MHz, the demonstration of the em-
On average. the length of the embryo increases bryonic vesicle and the embryo is usually delayed by
from 5 to 12 mm in the period from Days 25 to the 30 about 5 days. At a frequency of 3 MHz the embryonic
of pregnancy (PIERSON and GIN11lER 1984 a, R EEVES vesicle is visible after Day 25 and the cmbryo after Day
et at 1984, CURRAN ct al. 1986 b). If it is clearly visible 30 (TAltmJRIER et al. 1983). Studies on thc accuracy of
its heart beat should also be detectable. The heart is thc ultrasonic pregnancy diagnoses indicated that at low
first organ of the bovine embryo that can be identified frequencies of 3 or 3.5 MHz an accurate negative
by ultrasonography. It can be detected only a few days diagnosis could be made by Day 35 to 40 and a positive
after the vcry fi rst cardiac contractions occur during the diagnosis not earlier than from Day 45 (TAVERNE et al.
course of organogenesis. Around Day 20 the heart 1985, CHAFl--AUX et al. 1986).

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126 UlrrtlSQllogmphy ill tlte cow

fol g. 2.89: COIlCI:ptUS wilh cmbryo (ind amnion (2 1lIT(J\\'S) on Hg. 2.90: PholOgrnph of lin embryo wi th surrounding amnion
D:ly 33 of pregnancy. Thc amnion roml~ a thin mcmbr.Ulc and 3djoining 311:ulIochorion (AI) on Day 37 of pregnallC)'
which surround\ the embl)'O. Uhrasonogrum produced \\ilh (specimen rcmO\'Cd from the ulerus).
sector sc::mncr at 5 M I b~

"'il(. 2.91: Conceptus with cmbl)'O and amnion CA) on Day 40 fo·ig. 2.92: UltmsonogrJm of (I oooccplus wit h embryo (E) and
of pregna ..~'Y. The head of the cmbryo ..... ith the ;mcchoK: a single placcntome (P) on Day 33 of pregnancy. The plOlccn·
round area of thc dc\'cloping cye (arrow) lie.:. tOwards the left. tome protru~ bud·like into the lumen.
The c:tl:M11·rump-lcngth (CRL) is 2U mm. Ultrasonogram
produt'Cd wilh ..ector sciinner lit 5 Mi ll.

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Pregnant:)' 127

2.3.2.4 Day 31 1040 of pregnancy diameter varies between different scdQI'S of the vcsicle
and there arc also differences bctv.-ccn individuals.
The crown-rump-Icngth (CRL) of the embl)'O Even during an examination the embryonic vcsicle may
reaches 12 mm around Day 30. 15 mm by Day 35 and undergo changes in diameter due 10 intestinal imd
20 mm by Day 40 (PIERSON and GINTImR 1984 a). uterine movements. It is thus not mrc 10 find variable
Qmlsiomilly around Day 30, but usually around Day 35 vesicle diameters when Ihese arc measured during a
the amniotic vesicle becomes apparent (Fig. 2.89 and single ultrdSOund examination.
2.90). A few millimeters away from the embryo it forms The placcnlomes also become visible for the first
:1 ....cry thin. arched, hypercchoic line which surrounds time between Days 30 and 40 (Fig. 2.92). On average,
the embryo. the first apJX:arnncc of knob like protrusions can be
Around Day 40 the mean diameter of the embryonic e~Cled around Day 35 (CURRAN 1986 b). The first
vesicle is about 2.5 em and the CRL of the cmbf)'O signs of placcnlomcs are usually noticeable in the area
about 2 em (Fig. 2.91). The sizes ofcmhryonic vesicles near the e mbryo.
vary, h<M'cycr (MOLLER CI al. 1986). Sometimes the

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f"~1.<U:h~>CCtionIlIR...p.ar<.... ""D:o)'57ufprqn.ul<).("Jbo.'ious
""'f..... uuna:nlt,,;(O) .... vt<Hcoolhohead.l'... .....t>ilo;:aIwnI(U)
"'''' In I don.al d,reo;1iun and 'hen fr>lk"" I ,,>u1>e .k"", II><! "'crin< .... ~
=:""""'.TO'... rigbttA""'_OOd<nnl .... rhca:tooa.uf.

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l'n'8l1(lIIc), 129

2.3.2.5 Day 41 to 90 of pregnancy include the demonstration of embl}'Onic or fetnl struc·


tures, respectively. From the dingnostic point of view
From the first day of de\(.'Ction between Days 20 and the only organ that is available at this stage of pregnan-
30 until Day 50 the embryo grows at a rate of approxi· cy is the beating heart. In contrast, aft er Day 40 the out-
mately I mm per dny (PtERSON and G1NTIlER 1984 a, line of the fetus with its head, extremities and umbilical
KAHN 1985). By Day 50 it .....ould thus have a CRL of cord become visible (fig. 2.94). From Day 35 to Day 45
about 35 mm (Fig. 2.93). The cross sectional diameter the sonogmphically visible changes that transfonn the
of the placental vesicle also increases appreciably be· undifferentiated, primitive embl}'O into a fetus with a
tween Days 30 and 70 of pregnancy. It reaches 2S mm distinct body fonn. take placc(WINTERS et a!. 1942). At
by Day 40, 35 to 40 mm by Day 50 and 50 to 60 mm by this time. first ossifICation centers can be noticed in the
Day 70 (KAuN 1985, CURRAN et al. 1986 b). The largest vcrtebrae, ribs and pelvic bones, on the upper and lower
dilation of the uterus usually occurs in the area of the jaws, on the femur and humerus as ....'C II as on the radi-
embryo, while the embryonic vesicle in the contralateral us, ulna and tibia.
hom can be substantially narrower.
Around Day 40 ,\ stage is reached when the sonogra-
phic examination of the pregnancy can be extended to

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130 Ultrasollography jll the cow

.1g. 2.95: Sagiual section through a pregnant uterine hom on Fig. 2.96: Photogro ph of a sagittally opened uterine hom on
Day 4 1 of pregnancy. The anechoic conceptual \·csidc ap- Day 55 of pregnancy. The folds of the uterine w-oIUlead to the
pears to be divided by folds of the uterine wa ll into 4 ( I. 2. J. wmpanmen tali:altion o rthe pregnant uterine hom.
4) companmcnts.

Fig. 2.97: Nuclear magnctic resonance image of a uterus on FIg. 2.98: Photograph of II sagittally opened. pregnant uteri ne
Day 55 of pregnancy. Inside the pregnant hom are folds (ar- hom on Day 78 of pregnancy. The folds of the uterine wall
TOI'o"S) that reach venically in to the lumen, as well a~ placen- stroightcn out as the pregnancy progresses.
tomcs (P). On the right is the ovury (Ov) with a a ; oilihe left
is the non-pregnant hom (oph). The head ( H) . spinal column
(S) and the bright echo o f the live r can be n:cugnU:t.'d.

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17egIlQllcy 13 1

The pseudo-ampullary appearance of the pregnant result<; until Week 6 of pregmmcy. At this frequency the
uterus is particularly pronounced during the 2nd month resolution is high enough to detect even small fluid
of pregnancy (Fig. 2.95). Atlhis time numerous well de- accumulations as well as the still smilli embl)'onic struc-
veloped uterine folds bulge into the lumen and divide tures. In addition. the SCo't nning width of about 5 em of
the early pregnant uterus into compartments (KAliNet the 5 MHz probe and it<; scanning depth of about 9 an
al. 1989). In a sagittal section through the uterus the are adequate to rather completely depict the conceptll.<;
folds run vinUlllly in §lrnig.ht lines between the larger which is still quite small.
and lesser curvatures of the pregnant hom. lhey arc The lower frequency ultrasound ....i th its deeper
sic1de shaped and project often 2 to 3 em high into the SC<lnning depth has important adv.lntagcs during the
uterine lumen (Fig. 2.96). They stand almost vertically more advanced stages of pregnancy. As a result of the
10 the outer surface of the ulerus and are ammged deeper field of view, larger parts of organs and wide r
t ransve~Iy, in the fonn of circular folds, in relation 10 segments of the pregnant uterus can be depicted. When
the longitudinal axis of the uterine lumen (Fig. 2.97). a 5 MHz probe is used the CRL of a fetus may not be
Their regular spacing and their prominent infolding measurable after Day 60. Around this time the CRL
fonn a pscudo-compartmentillization of the uterine reaches 6 em which is the maximum scanning width
horns. of most 5 MHz linear probes (WUI1"E et al. 1985). If a
As pregnancy continuc,<; these circular folds of the k,."..er freq uency probe is selected the fe tus mlly still be
uterine wall grnduillly retract so that by Day 70 the com- SC<lnned in tOIO until Day 90.
partmcntaliz;ttion becomes less prominent (Fig. 2.98).
If a linear scanner is used for the sonogr.lphic exami-
nation of the conceptus a 5 MHz probe will give goOO

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132 UI/rrISOIllI8rtlpl!y ill rlrl' co ....

~". 2.99: Pn:gn:ml Ulcrus wilh a plao::nlOmc (P) on Day 102 Fig. 2. 100: Placcntomc with its hyperechoic border in a preg-
of pn...gn:tOC)'. 111e hypefC<"hoic membrane of the nliantlXho- nancy on D:ty 162.
rion (nrrow) runs ncross the pla(:cmomc.

~lg.2. 101: Numcrou~. tightly packed plaocntomcs in a uterus Hg. 2. 102: Uterus with the h)'pcrechoic amniotic membrnnc
on Day 191 of pregnallC). Ikt\l,'l..'Cn the p~tcentomC!'i a ,,"'dion (alTlM') IOohich scpar:ucs the echoic umniolic nuid from the
through the nmniotil; vc..;dc (Am) with it\ more l,.'Choil; am· hypocchoic allantoIC nuid. l"NgnallC)'Oll Day 191.
niock fluid c;:an be Sl,:cn. The allantoic "uid (AI) is mue-h more
hypot."Choic.

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£..3.2.62ndand3rdlrimcslcrofprcgllant)' =;'!;\;dcc l l "lurror"cntsanoJv~'«XJ>ityoflhcanmi"ti...


fluid.AlthcpKgRaTII.')'~lhc>Ie"'flcaiommay

'!::~n::~=~~'~: :w.ome Iso<>\o·-1'Iorm·li~e "ppeanmccand lurbulen<.n


within,hc~mnioti<;nuklmaylx=comcvc:ryobvinus. rhe
""'1kl:retlJs.lherlal'Cnl~iIi§""Uili§thcmrm. allanl(l;'" fluid ~mainsancd1oic for many month<.. Only
~~~,::monandallanl"",amllhe"nuKkcan duriog the si>(\h nlOl1lh ofpn:g.nallC)' 00 a few ochoc.
<larttoappearini,,,·hichlhenincn:a<jCrapidlyin<kn.
'The pbttnlOlDe' l>ulge 1010 lhe u\Crine lumen in wty.l'rumM<K1,h8umdsbonlybcforehirththeect...-
'!-W ~harac!~",nc aPl"'arano:: (lIg. 2.9':1). During the l:en"~lyoflh<: alLamoi(:f1uidmaybevcrysimilarl(}INII
~andlbirdLrime<lersofpregnancylhcyan:fn:. mtM amniOhcfluid. 1~'~ryprom'''''''Ilt, thin echo line:
,...1Iy<urrourkk:dbyJ I lo~m~th..:k . ....,ryhypcr. of 1M amnion Ctln nearly aNo'aysbe T'tOOgfIl7.ed as II

~.~::~~~·;;~:il~:;~~r:::: f1oal;ngmrn~driflingwilhinthcdarkplacental
flud..
~C1nO<;c&<ion"Uybe ...'Cnmlhcll'ccnlcr.;. lnm"ny rhe=lI1"hi<hthektw.e<c;mnothcrcachedhy
~1""placcnlt.l1De'l"'~cIooo.:toead!othcrthal lrnnsr=al..........,..phyou;urdurinalhc """ trirnc.tcr
=r~~!I~~I~n he >een <K1 a Slngk: :IO.JIIOgf'lIph..: 1m. ofpregnancy( ..."o.ap!cr2.4.3).Duringth;"1;m~d;ag·
I100I''' conduo.i<>n<can be d...~"n by ima&Jng tho: III~"'"
..111..:n:.... t""'ll/llniol;",flllid~rn:tJmanccboicdurin& rdJed .. ilhplac:cmalfluO(k,thepliICCnt~ortheam·
~::~~f~'1c'l;:;::~~~: nion~ndalianlo; .. l n~ddition.lrall'iCUl"IICOII.~~a·
phif;~i""l101lcanbeCOl'6i<krm..
~(Fi"2.1021m12.LIi2).Tht'yarccaU<edbylh~'n.

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134 Ultrasollography ill the cow

"'ig. 2.103: Twi ns. which resulted from insemination and oont ralateral
embl)'O tm osfer, in a CC10II on Day 41 ofprcgnancy, The transve rse sec-
tion through the uterus shows o ne fet us. surrounded by its amnion
(arrow), in the lert uterine hom and another fe tus (F) in the right
uterine hom,

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Mllitiple pregnancies 135

2.3.2.7 Twin and multiple pregnancies organ are difficult to obtain. To diagnose a twin preg-
nancy the fe tuses then have to be found one after the
The sonographic diagnosis of a twin or mUltiple othef. This can lead to dillgnostic uncertainties. because
pregnancy can be justified if tv.'O or more embryos Of fe- it is not always clear during the course of an examina·
tuses ....'C re dearly visible. If two conceptuses can be tion whether the second fetus that is found is not
depicted simultaneously on the monitor a sonographic perhaps another view of the fi rst one which has mi·
diagnosis of a twin pregnancy is reliable (Fig. 2. (03). If grated back into the picture.
the two conceptuses lie in opposite uterine horns they The second month of pregnancy appears to be the
can only be seen in one picture if the sound probe is most suitable period for diagnosing [lAins. This period
turned into a virtually transverse position. A probe encompas"cs the stage at which from the embryos are
which allows multiple scanning planes during intrarectal first easily visible at around Day 28 to the stage when
applicmions is pan kularly suitable in sueh cases. So, for the adYanccd growth in the size of the fe tuses prohibits
example. the use of a linear probe which is held length- them from being depicted simultaneously.
wise inside the rectum produces mostly sagittal sections
through the uterus while trunsvcrse images through the

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F"," 2.JI).I, AooomWI"O&fW'C)'38a.y.ofto,;"",mi",,'..,.,


[""""' ..... <ltboimflOf><liDt;cm~.,.athanolht>mall
."""""<I~ftuod(F)oIId'''''...wI>I«<'A'ho<",·
bryu(t)

.~ !.I""', 1.1"-_"""" of r..1Il moovrufo<a'.,., ill. \lOll"


34~ d:o)~ ar,O' ;n",m",","", _n..: nwmm;.'< "",r""" ch.c to
'hoprubcpmdu<u ~ ~l"'rt:clJ.uO:l""'lI"duc\Oi",nony""n·
p<>noefI .. (artuoI~).Tholupo/>qpUl<'Auh _ _ 'ft'h"'
""'. """"n"thc<kpo:l.,., <'Alk"'l't,ktal >InK1u_

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Ulerillepmhology 137

2.3.3 Uterine pathology meters into the fetus so that only:l narrow, hypcrechoic
peripheral area could be identified. The tissues that lay
2.3.3.1 Embryonic death deep to the fetus did not reflect any ultrasound echoes
and remained anechoic (FISSORE el at 1986). Obviou.~­
First signs of an impending embryonic de:nh are an Iy, the mummification process lelad to tissue changes
undersized embryo and a reduced amount of embl)'Onie which c..used an increased absorption of sound waves in
fluid. The death of a w nceptus can be reliably diag- the superficial tissue layers.
nosed once the embryonic hean beat has stopped. Between the surflacc of the mummified fetus and the
In cases where embl)'onic death have been observed uterine waU werc no hypoechoie area.. that could be
between Days 25 and 40 of pregnancy the hean beal seen as accumulations of fetal fluid.
persisted fo r several days after a retardation in growth
had been detected (Fig. 2.104). Sometimes the hean
beat did not cease until several days after first suspicions 2.3.3.3 Fetal maceration
of an impending embryonic death, based on retarded
embl)'Onic growth, were raised (Fig. 2.105). Shortly be· Apart from the well known clinical features some
fore the heart wmes to a complete standstill, one can sonographic signs of fetal maceration were seen in a
often notice a markedly reduced pulse rate (KAs"rEuc case of this foml of a pathological pregnancy. 11lCre was
et al. 1988). The nonnal embryo at this slage ,,'Ould a very distinCi difference between the echogcnicity of
have a heart rate of about 150 per minute (KAt IN 1989 the allantoic fluid and that of the amnion (Fig. 2.1 07).
b). A .. the resorption progresses the amount of embry- Due to its lack of reflCClmns the allantoic fluid appeared
onic fluid will decrcase, while its (.'Chogenicity will in- virtually black, while hypcrechoic. regularly distributed
crca<;e. What started a.. floccular reflections al the be- echoes whirled around inside the amniotic fluid. These
ginning of the resorption will develop into a mas.... of were interpreted to ha\'C been caused by the increased
snowy echoes. The embryo then looses its typic.. 1o ut· ccllular content of the amniotic fluid resulting from the
line and becomes very indistinct. disintcgratmn of the fetal tissues.
Within the echoic amniotic fluid , fetal component..
were identifiable. The fetus and its organs were, how-
2.3.3.2 Fetal mummification ever. much less distinCi than in viable pregnancies. Due
to the increased echogenicity of the amniotic fluid the
In caSC$ of pregnancy failure in the form of fetal fetal outlines contrasted less than nonnal. Structures
mummification the uterine ultrasonogrdms usually con· within the fetus ....-ere only vaguely recognizable. This
tain vcry little conclu...ive infonn:nion. Immediately be- wa... assumed to have been the result of the onset of
low the utcrine wall hypcrechoic foci can be detected post-mortem changes. As a rcsull of their hypcrechoic
(Fig. 2.106). No fetal body parts have been identified in echoes o nly bony p<1rtScould be differentiated from soft
the mummies examined by trdnsrectal ultrdSOnography tis.... ue components (F1SSORE et al. 1986).
thus far. The sound waves only penetrated a few cenli·

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Postpartllm menu 139

2.3.3.4 Postpartum uterus distended by fl uid several centimeters in diameter


(OKANO and TOM1ZUKA 1987). At this time a distinct
After birth the most obvious sonographie structures reduction in the size of the caruncles can be demon-
in the uterine lumen are the caruncles (Fig. 2. 108 to strated ultrasonically (Fig. 2.110). Smaller fl uid accu-
2.110). Depending on the direction of the sonographie mulations can sometimes persist until the end of uterine
scanning, a variety of sections through the carunclcs can iO\'Olution.
be produced. Areus of differing eehogenicity can be When the uterine involution runs a pathological
secn on the round or oval cross sections of caruncles. course in the fo rm of a lochiometm the uterus can be-
The most superficial hlycr is depicted as a hypcrechoic come extremely di...tendcd (Fig. 2.11 1). In such cases
layer. The deeper tissues of the placentome are rela- the placcntomes often ean not be seen. A hypcrechoic
tively less echoic. resembling the image generated by area can sometimes be seen at the floo r of the uterus.
loose tissue. From the site of it.. uterine attachment This is caused by the sedimentation of tissue break-
hypcrcchoic lines often radiate into the depth of the down-products and cellular clements in the lochial fl uid.
caruncle (Fig. 2.1OS). Certain sonographic features of the postpartum
The uterine lumen often appears to be virtually 0b- uterus are also detectable in pathological situations
literated, even as early as the first day after calving with such as endometritis. For example, the lochia can show
no larger accumulations of fluid recognizable (Fig. the same echogenicity as is seen in many cases of
2.1 08). In many cases. hov.'CVCr. lochial secretions C'd n endometritis (Fig. 2.112 to 2. 11 5). The caruncles are
be seen inside the uterine lumen (Fig. 2.109). They then used as characteristic distinguishing fea tures. The
show the floccular eehogenicitics which are typical of regressing caruncles usually remain detectable until the
flui ds that contain cellular comp:ments. In such CIISCS end of the postpartum period. Apart from this - lind the
the cilruncles protrude like mushrooms into the rela- usual clinical features - the diameter and the asymmetry
tively hypocehoie uterine secretions. Even by two weeks in the size of the pregnant and non-pregnant uterine
post partum the normlll postpartum uterus can still be horns usually indicate a postpartum ute rus.

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140 Ultra,;o'j('/(ml'hyi"tlieco~

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Uterine !)(JlllOlogy 141

2.3.3.5 Endometritis persistcd for a long time thcreafter. The development


of this increased echogenicity was also tested in excised
Auid accumulations which are detectable inside the uteri. In this manner it could be shown that the in·
lumen of a non·pregnant uterus can be indico.ltivc for creased echogenicil}' did not originate from the iodine.
chronic cndomctritis. The amount of the secretion can but from the endometrium itself. After flushing the
vary considerably (Fig. 2. 112 and 2.1 13). In many cases iodine solution out of the excised uteri the increased
a fluid filled lumen can only be detected in short seg- echogenicity persisted.
ments of the uterus. In scvere endometritis cases, how-
ever. both uterine horns can be distended to several
centimeters along their entire length. In mild fonns of 2.3.3.6 Pyometra
endometritis no lumen may be evident ullrasoniC'o.llly.
Their echogenicity distinguishes the endometritic The most extreme fo nn of endometritis. the pyome-
secretions from other uterine secretions as are seen dur- tra, is sonographically characterized by a uterus which is
ing estrus or pregnancy (FISSORE ct al. 1986). Anechoic considerably distended by an accumulation of fluid . The
fluids usually only occur under physiological conditions secretion inside the uterus contains unifonnly and dif-
(Piel1iOn and Ginther 1987). The fluid causcd by in- fascly dispersed floccular reflections (Fig. 2.1 15). The
flam mation contains floccular echoes. The cchogenicil}' echogenicity of the reflections depends on the consis-
of the fluid can develop to snow-stann-like images and tency of the pyometra flu id. If the secretion is very thick
can become so scvere that it appears nearly white. Dur- and contains many cellular clements its echogenicity
ing observation periods of some minutes of extensive may be the same as that of the uterine wall, whereas a
fluid accumulations it is usually possible to see turbu- more liquid contents will appear much darker than the
lence within the fluid . surrounding wall of the uterus.
The value of transrectal ultrasonography in diag- The thickness of the uterine wall in the pyometra
nosing e ndometritis in the cow must be judged with cau- cascs examined thus far varied considembly. Thick- and
tion. Unless endometritis is accompanied by the accu- thin-walled pyometras can be found. Only when the wall
mulation of fluid inside the uterine lumen the usc of is se\'Crely thickened can th is be used to distinguish a
ultrasonography will usually not detect pathological pyometm from a pregnancy. The diagnosis of a pyome-
changes of endometritis. If the uterine lumen is, how- tm on the basis of its ultrasonic image must be made
ever, distended with fluid sonographic diagnosis may be with appropriate care. In advanced pregnancy the
possible. uterus is also distended and its fluid contents can be
A noteworthy phenomenon has been obscr.'Cd in considerably echoic. For a reliable sonographic diag-
cases of endometritis after intra-uterine treatment. nosis of a pyometra an effon should be made to depict
After an iodine solution had been instilled into the uter- the entire course of the uterine lumen with its abnonna1
ine lumen the luminal surface of the endometrium be- contents and 10 e nsure that no fetal pans or structures
came hypcrechoic (Fig. 2.114). The hypcrechogenicil}' can be found inside the fl uid.
de"eloped immediately after the iodine infusion and

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."l.ll ' : SdIIIIN' .. ~""'oloariouo"""""""pIaoeI


andlheirFH>fl>elldo,,,,,,.IJMedian"'~tr.!~ion.b)hori­
_uol!lOC!'<>n,C) ,fII"...,,,,,,or ....... ...:tioo

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www.vet4arab.co.cc Blj..iM~ffiW 143

t'K)n,\ncont"*t.\)">si'casyto<klwit"~rt1;m~OT
scanncn..Thc"ariou'IClpOgrJphical JlO"iliomofthc fe-
tal organs can thus 00 traced irre.pc<.1ive oftl!c rdativc
positioning of the fetu' in<ide the uterm.
Wh~n:as in !he ""'" of an cmhryoOl1Iy ils inlra· In mosIC3.<;csthe"""t lim iting foctor in depicting
. positionandlheoutlilkof it,bodycanbca .. the oomplclc fClus is tnc limiled pcnclrati<:m oflhe
bylransrectal uhrasonography. a greal number soond w aves.lfthefelUSIK."Swryncarlotheprol>ca5
macm-anatomi""n)'di.ainguishableslructurescanbe MHz '!ector tmnsducer can be u",d for bctter imagl."
cd~' the SIlJnC proccdun: in the Ix:r>inc fChL~ quality. For the imagingnf.lructu=that arefurthcr
"J990j.Gcn<:mlly.lhccmircfclusC<lfIbcc""m- away from the prol>c it i, fa,maIlle to switch to a 3.5
sonogt"aphkall).· (KAII.~ 191'\9 b). The SllCCeSSwith MHztmmduccr.
indr.'idualorgansrnnbedepkled,... riesconsid Fetuses can ""'lJ=vanabie positioru;insidc thc
"ndd<:pcndso" the Slage of the pn:gnancy. Ihc uteru•. A "andardized"""",nclatu",.tmuIdbe adop-
·"terinc position of the fetus and its mohilily (scc tedsothatilWmhcpos.,ibietode.crihethep<ll'ilionnf
cr2.4.3).lndividualorgansorbodj.' parts""nbc thcfctus.Inc sonographicexamiMlionplane' and lhe
tifiNlwhenlheyhav",reachedal leasla,izethale:<- "hm.ouod images in unambiguous terms. 'Ibe n~mcs
lhe minima l rcsolOlion capabil ily of the scanner usedbelowtodescribethediffe",ntsooogJ'aphic
and;fll!cyh,,,"cachar,,,-1cnsticllOnogrnphicap- examinalion plane. thmngh the felu, a", based on the
anccthalaliowsthcmtoood;;tingoi,hcdfromad- n><:><klofaca l fl)' i ngi~,idelhcutcrus(Flg,2_ 116).Two
It",,,,," , Theearliesltimeat which ,..,rtainorgarui forms of Iongillldinal sections all: lk:scribed. A!oOt1O-
vi,ible i, dosel).' connecl" d with the typical gmphicpJancJlO"itioncdc""'1IybclW ...... nthclinca"lm.
<oforganoge~ aodthespinalcolumnt<;caIJedamediansection;ifitts
Rased on cxp..'1icncc thu, far the impK"SSion has moved to the .id<: it i~ referred to a, paramed ian or
g<lincd thm """1or .... nners"re bcttcr suited for sagiual ....-ction; ifil is dircctcdvcrtically act'OII' the body
""'nogra~irexaminal"'nofthefelusina"""nced axi.il;"«illcd a irJIDVCn;corcIl.."6SSCCIion; if il is
aocylhanlinearscanne",.Thedttpvie"'i ngf~ ld directed lalcru--latcmU}';t is a horizontal SC<.1ion. ln
If..,~orscanncrsOo;widcrthantha\oflhelincar additiontothep"'itionofthesonographicpl~the
n.. ·lbismakcstl!cimagingofllugcrpansofthc path of the soond ... avcs through the fetal body.hould
po!<Sibk , Jnaddition.lhebcttcrmancuvcrabililyof he d<:scribcd. If the calf lies wilh ilS spinal column
small sector probe:'l imide the rectum ma/;;es il nca~lOthctmnsJucerand;scxamincdwi lhthe
' rtodepictvariou<sectionalplanesthroughthe sound w"ve,dir«1ed fwm the spi!lllJ column to Ih<:
Ius, Doc 10 the l-shapc it isdiffoculllOlumlhe linea aibawe'pca1:ofa oo""""ntral sound beam, and
oftbclincar,,;ann.:rfrumibUMl,,1 kmgitudinal nfavenlrodorsal <Qund hcam in tr.e "PJ">'titc direction
.. n inside the rectum to a more traru,ve"", JlO"i

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144 Ultrusol1ogrophY ;1/ the cow

fig. 2.11 7: Ventrodorsal s.1gittal section through a fetus on Day 48 ofprcg.


nancy. The head lies on the left. The hypocchoic developing eye (E) can be
reoognizcd.

Fig. 2. 11 8: Transverse section through the head of.1 felUs .1t the le...eI of the
e)"CS on Day 102 o f pregnancy. In the emnial aspects of the C)"CS the oval
lenses (:HTOIII"S) can be secn. Below the eyes is the spherical ccrcbnll cr.lni-
urn (C).

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Bodl//! /efltJ 145

2.4.1.1 Head tures become visible within the eye (Fig. 2.1 HI). These
consist of arched. echoic lines which o riginate from the
Next to the extremities. the head belongs to those llnterior and posterior .......1115 of the lens. With II hori7..on·
body pans of the embl)'O that can be recognizcd rela- tal section through the heud the eye balls hnvc perfIX"!ly
tively early. The obvious difference in impedance be- circular cross scctions. In saginal sections (in ophthal·
tween its p.uts llnd that of the surrounding fetal fluids. mology also referred to as \'enical scctions) they arc
its characteristic profile and a marked narrowing in the slightly oval. With the 5:lgittal beam the interpalpcpr;tl
region of the neck allow for a d ear differentiatio n be- space becomes visible from about Month 6 of pregnan-
tween head and body from about the fifth \\-'Cek of preg- cy (Fig. 2.1 19 and 2. 120). At times the eyelids are clear-
nancy. ly open and blinking movements of the lids can be ob-
Apan from the facial skull the dark area of the devel- scrved. The relative echo enhancement by the hypo-
oping eyc within the head can be recognized on about echoic eye ball makes the retrobulbar nrca uppear more
Day 40 of pregnancy (Fig. 2. 11 7). Initially, the embry- echoic than the neighbouring 1 i.~ ucs at the 5:lme depth.
onic eyc i... free of echoes and no ocular structures enn be
differentiated. From Day 70 of pregnancy echoic struc-

FIg. 2.119: Saginal section through the L')'C of a fetus on Day rig. 2.120: Sagittal section through the L')'e of a fetus on Day
197 of pregnancy. The head lies dorsally against a pl:tccntomc 205 of pregnancy. An C)\! lid projects from abo-.'C the eye to
(1'). The split (arrow) bct\\,'CCn thc cyc lids is open. The pos. lhe left. 1bc retrobulbar arc;1 slJoy.'!l rclatr.·c ccho enhance-
terior curvature of the lens (L) can be secn. ment (E).

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146 UllrrJSQlI()8rt11Jhy ill Ille cow

Fig. 2. 121 : SagiuaJ St."Clion through a fetus on Day 61 of preg' .". 2. 122: ~Iorizon t al SCdion through the crnnium on Day ~
nancy. In the head hypcll.'c hoic ossiflC3tion centers can be with the cervical area on the righ t llnd the nose on the Idt.
seen in the mandible. maxilla and facilll bontS Cranially 10 the C\Jrvcd reTCh ..... ! roof lies the "PhcnoitJ bone
(S). Inside the brain are the two Illteral ventricle.<! (tv) with the
falx ccrcbri between them

.lg. l .I2J: Tangential sagiual section through II fetus on Day


127 of pregnancy. The fetus f:I('cs to the left , The e)'c with the
Jens (L) and the O\~.JI ecrebml e....lIlium are dcpicled.

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DoI'if/ere/lI! 147

The development of ossification centers provide the From Day 50 to 60 of pregnancy the bones of the
basis for the sonogrnphic depiction of bones. Ossifica· cranium fonn a nearly closed, hypcrechoic 0\':11. A
tion centers that develop e"fly on in the skull bones re· transvcr.;c section through the cranium shows a round
suit in the depiction of hypcrrcnective structures in the cmnial cavity (Fig. 2.118). A sagittal section through the
head from the end of the second month of pregnancy cranium results in the depiction of an oval cranial cavity
(GJESOAI. 1969). The first large hypcrcchoic structure is the longest diameter of which lies in the frontooccipital
found in the region of the mouth (Fig. 2.121). It is direction (Fig. 2.123). The cr,mial cavity can be seen in
found at the site of the mandible and depicts its charac- toto until Month 7. During the last two months of preg-
teristic future shape . At the end of Month 3 of pregnan- nancy the bones in the roof of the skull absorb so much
cy the ossification processes have progressed so far thnt ultr.!SOund that the energy renectcd from the bones at
individual skull bones can be recognized by their typical the base of the cmnium is not sufficient for the produc-
shapes (Fig. 2.122). tion of an image on the monitor.

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148 UllrrlSOllography ill tile cow

FIg. 2.124: Horizontal section through a fetus on Day 93 of pregnancy. The


forehead points towards I o'doek, thorn)[ and rump towards 7 o·dock.. In-
side the cmnium the laterul ventricles (alTOYo"5). falx c:crebri and the third
Vl.'ntricle (.-an be secn.

HI

.'Ig. 2. 125: Schematic presentation analogoUli to the sc:tnning FIg. 2. 126: Tmnsvcrsc S(.'Ctioo through the cmnium of a fetus
plane in Fig. 2.126. Cross st:ction through the anterior brain at on Day 147 of pregnancy at the level of the mamillary body
the level of the mamillary body and the pituitary (P). lit hypo- and the pituitary analogous to the diagram in Fig. 2.125. The
thalamus, IIv left lateral \'Cntricle, rIv righ t lateral \'Cotriclc. I inner cavity is panitioned by the echoes of the \'Cntriclc and
Corpus mamillare. 2 Falx o:rcbri. 3 Sulcus splenialis. Ill. third the Falx c:crcbri.
ventricle (adapted from SElFEII.LE 1984),

----------------------------------------.
o zas 10 radIVO
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www.vet4arab.co.cc /W"'III'/ttw' 149

Tbc;nnerraviryoflhi:cr.tnium;'clearlyk!l6echoic ll1f;yronlrastagain>llhercmaJningh)'lXlCchoicparlSol
its surrwnding cr~niai bonl.--s. Al a rclalJVCiy early thebr.tincortcx.A~theprcgnancyJln>gre»SC>thchrnin
;tOClntaimrcl1ca~oh'llI)'inginlC1\$ltJe."hidt <lJh!<tallCClk:"'lopsfa.'\Ierthanlhcvcnu;des_n~lling
tCrlQl11~rcnll'ilruofthebnin.Arrontai in.n:I,u;y"~_oftherchogl."I1ici1yi...o,,thect'1l­
tllruugh the CflInillm inproUmitytoilllrool"rc- nial cavity. The hlroem:tauicstnoctUfeSUl tbc>ianlryuf
... stripe like, II\nliahI edIo .. hidt ruMcemllilly lhehr.oinoriginalC flQl11 the mcnirt:gC$",ith the chorioid
crani.1 to caudal (Fig.2.122and2,124). Ilwxarc plC1 ... aoolhelater.tl",mricies.where.flllchrainti!l-
rdlectioM""uscdhythefaJxccrc~riwhichlio.in !'UeI\the"",,~~rek,..e<:hoic.
nthel'o.uhernk.pbe=oflhebn.inanddMdeol [ntheareaoltbcmouthandllOilemoMoftheJlroc·
cnuuuminll)l'MlS)'I1UIIctricaJhal\'l'S.ikl'o.ccndli< fUrail)picaloflhlSl'ilrtoflhefaceanbciOCnlifoed.A
toemraled>oandthehypen:choic~mPalol ~12 oection lhmugh the IU1tenor pan of the
ct'Ilni/l1 roof a hori;ront~l
"'-'<:tion through the crani. moulh show!; the lateral na..... lwalls oswell a<lhe en-
ll:\'Cals two round ecOOe. on eilher ~tde of lbe ccn· !ranee to lhe nll.'\IIl pa'iSa&" (Fig. 2.(27). lInwmcath
line. 1llCY!cd>Qe5otiginate frum lhe laler.tl """. I~thebrighl~oflhehllnlpalaleandthed"vcl_
andlheird>orioidplc.<us(Flg.l.ll5~nd2126). opIlIg tccdl 01 the matilla can be !ittn.

••. l.I~7:Tra"""''''''.,,"Iionllt!Qug.hll1c''''lcriorparlofthe
nooulh 00 Day 2.1'1 of prep"')'. flc:h,.. tbc na.. 1 ""fIlum;"
Ibtll)pen:doui<ln:.IIottbehardpoLue{l'j.U..... m<1Ilhlhil
Ibt"""k""",lo1tW,.;pttrclh(n",thcmmDo.cube

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150 Ultmsonogmphy ill the mw

.'Ig. 2.128: Tmns\'crse SI.--ction through the mou th and nose of I-1g.2.129: I':lmmedian sc..'Clion through the facial skull of a fe·
a fetus on Day 161 of pfl!gnflnCY. Staning from both edge., of IuS on DOIY 100 of prcgnOlOC)'. The nose (N) pomb upwllrds.
the hypcrcchoic hard palate (I') the dc.;eloping tcelh arc pro- The mlt~illa lies on the left. the mandible (M) on the righ t.
ducing long !>had!)w anifacls. l\ boo.'C them arc ~t ructurcs be· ' 11e tongue (J) projects from the mou th.
longing 10 the !JliSal lurbinOltcs. Wh isker hair.! project a"""JY
from the muzzle at II and 3 o'clock

.' ig. 2.130: T angent ial sagitl.lll section throogh the nose and f'1g. 2.UI : Paramedian scaion through nose and mouth ora
mouth of a fe tus on DlY 185 of pfl!gnal'lC)'. The mouth points fetus on Day 184 of pregnancy. The nasal Clivity is defined by
ullYo·ard~. the ma.~ilI:t OInd nostrils (N) lie on the right and the the nasal bone (N) tJorsaUy and the maxilla (M) \'Cnlrally. At
mandible on the Jeft. 'Ille longue (T) .slicks out of the mouth 2 o'clock is the tongue (11. projecting from the mouth in the
and is dcn .."Ctcd in the direction of a nostril. din.'CI.ion of the IUlSIII entrance. 'Ilte mouth is .."ide open.

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probe pOSilioning lhoc fC\l1'lcan-


~:~~:;~=:~oc;r:!r;;~~";!i=
e\'idenl.Wilhoplimal
notonlybcsoxnlobiinkil• .,.eliOs,buIDOleliding ..
~imight.tntothean"1."'"Yofthcna<;;al1Urbioa!~ln Ulhcr forms of pI")'ing wilh itJ \onguc can beub!;c"""d
~llal sectl()[ltl\e turn'nHIC~ are ~"'n more_clearly (Fig.2.12<)and2.13().Sw~I"""inglOOVCmenIS""nal""
~ileddueWll\e;rupperbonl<:rbe;ng.rN(hc hc_on.n.,~p06itionfordcpictingbdal"ructurcs
~.~dot<anyandlhemuillaventrally{Hg.2.129 islhe~ual<rCIiun.().oca§ionaI~'."""'n\hc:headis
2..131) .lCClioned appropriately, the c~1\I em be oIRrol.-d (F'!-
From the timc ~\ which facial Slruc1Un!$ r,"i become 2.132).
.... rlyidcntifLablcnumemusoignsolfclal viability a""

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152 UllTUSOllogrophy ill the COIl'


----~~--------------------------------.

Fig. 1.1]1 : Image of an car in a fetus on D:,y 199 ofprcgnan- 1-'4;. l.I 33: Ventrodorsa.1 sagiuBI section through a fetus on
cy. Thl" tip of the car points at 2 o·clock. The face li~ to the Da) 61 of pregnancy. 111e head wil h the d~eluping eye (E)
Icft. off the image. lies on the righl. In the areas of thc m:tolla and mandible
bright ossirlCil tion tenters can be recognized. The spinal
column (arrow) is h)l)CI'(.'Choic.

c
b

f'ig. l . IJ.l: Schematic presentation of the ultrasou nd c.'Wmina- .-ig. l .135: Tmnsvcrse <;cajon through the thora.. :u the Icvel
tion of\·cnebrac. Depending on the angle al which thc sound of tile stomach and the Ii-ocr in a fems on Day 114 of pregnan·
Wll\'~ impat1 onto thc vcncbrn different ossification centers cy. Caudal view. Three OAAil'icalion centers (armlli'S) of a tOO-
may be depicted. a and b; double r~' of echoes; c: single TOW mcic"cncbrd can besccn. '~\'l curved ribs (R) stretch around
of echoes. the trunk. The h)~hOic stomach (S) lies Illx)\.-c with Ihc livc
(l) underneath il.

A'v'1C 1\0 Z"ISC eno Jrad' 0


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;L4.i.2 Spinal column 10 iCe 3 o..sir>ealion ocnlen in cach ,-cncbnl. lbcse


incluo.ieoncOlilloir>eatioorentcrincachoflhe..-endJr.1
lbc first tdJoi,cilructUM in thc arca of thc !<pine arrlIe5anda.mgk:oncinlhemiddlcoltlleYCflebntl
~bc:sccn a.early a.' ;n Wcck5of pn:gna.IlCY(CuM­ hody. AlllhreeOb'>irK:.a!ionrentersof"~in81e",nchra
~.etal. 1\186b).Altllishmo:athinlinc"'hich,<.lUCto Ulnonlybcvi<ualin:,j ina P<'rfCCllyhorizontai...:lion
~higheredlugenicity,"anoiIoutagail>.<tthi:5UfTOUIId­ throu&h the.o;pinalmlumn (f"i&.2.135). l bcc;:m<s.a:-
I!.t;;"""""'bewrncs cvidentinlhebactrqionoftht tion of the abdomo:n isalmollcomplctclyroorulinlhis
roo,?",(FllI.2. 133j. Individual ilructur¢; in the form of vicw.lfthc fClm ~ c~a mined in anyJoogiludinal ",:<:linn
~""''''""lOIhedisiingUishe<l)'C1. AtabouIWcd8 at_t-..uO&lirlClltiunrentcl1lpcr...,nehrucanbcsccn
pregnanrytht~l"pmcntoiycnebralOlilloirlCJOtiun ... anyoncim:ogc. lftbcexarniootionplancis""""'-"<l
tcnl>a<aPlKlrcntly~farcnough!lOthlll siigl\llyfmmmedianl....-anlspanuncdianthtUloSifo;:a..
~ll.hypcrcchoicfocicanhe<.lc(cC!ed(NOI)I~"andl)l( tion centcrinonc an:hasweli asthat atthc rentcr oilhe
11)"rA 1985 a ). OssiflC&lIonoilhe.-cnr:il""' ......... • ...,ncl!racanocsecnllJl!Cther.Tlll)'aresitualwdorsaJ-
~in thcycncbrnlbudyandtbcncxtcnd!;inlOthe lyand vemrnlly 10 thtspinal canal.. The narrow. hyp.>-
~bnllardlo.AtlheendofMonth2ofpn:gnallCY a echoic band of th.!'l'inal«<nal isdt:lincaledb)l~ .... rln¥
i--lIinuousstringufh}perechmcvertebnM.'canbcs..'Cn ofhypcn:choicdiso;"nt-..u~~ThisOOubierownf
~rulin&ontheangJeat ...·hichthe!lOUnd...","", brighl echocs can onIybc !<ftn on slightlyparame<.lian
I-cr 'IL'Cliom
the felU!;, dirre",m of the spinal cnlumn sectiun$oJ!l..-fctU5.
fc- bc dct*tedCl-'t;.2.114). It .. go;ocrallypnv.ible

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154 U1urlSollogmplzy III IIII! COIl'

.'Ii:' 2.136: Median ..celion through the cervical ~pinc on Day Fig. 1.131: Horizontal SI.'CIion through the head, neck and
161 ofprcgn:mcy. The spin31 cord (S) and thc \'Crtebral bodies trunk of a felus on Day 11 of prcgn:ltlcy. The head (H) points
(a~'ll) below it arc depicted. Shadow 3rtifacb appear in the to the right. A double fO',I.' of echoic discs of the o;pinul column
background or the \·crtcbrae. wilh :1 CClllrnl. hypocchoil;: t.'tn:d (arrow) runs through the
middle of the ned: a.nd trunk.

I-'i:. 2. 138: Sacral and coccygeal n:rtebrne in a felu~ on Day .lg. 2.139: Vcnlrodorsal median.;;ection through the neck and
165 of pregnaIlC)'. 'Ille sacrJI vertebrne lie on the right and arc anterior tip of Ihe thorax in a fetus on Day 101 of prcgnanqr.
individually n..·t:ognw-Ible. n,e tail (f) ~trelch("., 10 Ihe kft. TIIC head (out o(view) lies on Ihe lefl, lhe ccrvical spine (CS)
with the first f~ lhorncic venebrae \'Cnlrally. From the tip of
the thorax the ~tcrnum (51) runs 10 the din..-ction of" o·ckxk.

A .... e 0 Z"ISC
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Ikwiflcfems 155

When the sectional plane lies exactly in the median it The caudally extending tail of the fetus is character·
passes bel,",,'Cen the ossification centers of the left and ized by the large numbcr oflined up, discshuped echoes
right vertebral arches without producing any reflections. of the vertebral bodies (Fig. 2.138). The image of the
but it docs strike the ossification center in the middle of tail is very similar to that of the other pans of the spinal
the vertebral body (Fig. 2.136). After that only a row of column. A double row of echoes or a clcar spinal canal
disc shaped eehoes can be seen. The same h a~ns arc. hov.'C\'Cr. not evident. Not infrequently, mm'cmenlS
when the examination plane is mO\'Cd to the parame· of the tail can be observed.
dian o r if it is rotated from the sagittal towards a more Early on already, the \'Crtcbral echoes are very
horizontal plane. In these cases thc single row of echoes bright, and towards thc end of pregnancy they can be
may originate either from the ossification centers in the described as hyperrcflective. As the ossification of the
vertebral arches or from those in the vertebral lxxIies. vcrtebrae prog.rcsses. the typical image of shadowing
Further rotation of the probe around the longitudi· becomes evident in their background(Fig. 2.1 36, 2. 143,
nal axis produces the horizontal section with the sound 2. 144). From below the vertebrae hypocchoic Shlldows
beam directed latero-Iaterally. lfthe examination plane stretch into the depth of the image. llle width of each
lies at the level of thc vertebral arches. tv..'O parallel rO\\'s shadow is approximately the same as that of the bony
of eehoe.'i are again produced (Fig. 2. 137). These repre· structure in the foreground. The shadowing effect is
sent the ossification centers of the left and right verte- caused by the absorption of sound waves by the bony tis-
bral arches, respectively. Due to the natural curve of the sue which then causes very little sound to reach the tis-
spine a horizontal section through it will pass through sues immediately behind the bone.
individual vertebrae at different heighl'i and therefore If areas behind the vertebral column are to be ex-
no rows of echoes from the same structure of the dif· amined sonographk-,tlly it is useful to mO\'e the probe to
ferent \'Crtebrae can be seen. Commonly therefore. for a point where the spinal column is no longer positioned
example, a sho rt section of the thoracic spine may be in the path of the sound waves. In this manner the
seen as a double row of echoes, be continued caudally sound shadows. which originate behind the echoes of
as a single row and fonn a double row again in the lum· the vertebrae and run as parallel stripes th rough the
bar region. cntire image, can be avoided.
On the exact horizontal section through the spinal llle spinal cord is best depicted on an exact median
column of the trunk one can sometimes see, apart from section (Fig. 2.136). This approach allCM'S the sound
the reflectio ns of the \'Crtebrallxxlies. on bmh sides a W3\'CS to pass between the ossification centers of the
further row of disc shaped echoes. These represent the \'Crtebral arches on either side without generating any
sonographic images of the transvcn;e processes. In this rcnections. The spinal cord can then be examined with-
manncr the horizontal section through the fetus can oc- out any shadows interfering with the image quality.
casionally depict three parallel rows of echoes in the re-
gion of the spinal column.

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156 Ultrasollography ill the COli'

F". 1.140: 1·lori1.Ontal so::ction through the neck of a retus on Flg. 2. 141 : Horizonlal section through the head· neck junction
O:ty 209 of pregnancy. The anechoic inner lumen of the tra· in a fetus on Day 183 of pregnancy. Allhc cenler the lal}l1.,(
chea (T) is bordered by the two ro,....s of trnnsversc1y sectioned (t). to the left a pulsating blood \'csscl (arrow).
trncheal rings. TI,e head (OUI ofvitw) liC!l on thc left.

rq;. 2.142: HorU.ontal '\CeIion through 3 fetus on 0 3)' 10 of Fig. 2.143: Ilorizootal section through the thorax on Day 126
pregna!X.)'. The head (U) lics on the right. The two hyper- of pregnancy. The thorncic inlet i~ positioned at 7o'cklck.
echoic ro'\'S of no cross scC1ions (mTI)I.\'S) produce a conical From the rib CJ'mS sections Sh.1doo.\" are cast across the hean
shape of Ihe lhora.'(. (II). Lung tissue lies bctYo-een the hean and the diaphrugm
(llf1'l)Y,'S). Hcpalic ' cins Cflll be seen brunching from the cau-
dal (",lV',d vein (V).

Avk) SkO £ 'lSC e 10 "C


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Dorine fetlls 157

2.4.1.3 Neck sectional images. The thoracic skeleton can be recog-


nized by thc strings of numerous hyperechoic disc
Apart from the typic-J.I image of the spine (Fig. 2. 136 shaped echoes and their typical topographic amange-
and 2.139) the trachea appears as a domina ting struc- men!. On horizontal sections the rows of rib cross
ture o n the sonogram of the neck (Fig. 2.140). Its longi- sections of both halves of the thorax form a cone (Fig.
tudinal section features a prominent string of hyper- 2.142 and 2.143). The previously described phenome-
echoic cartilaginous rings which Slm o und the anechoic non of shadow anifaClS behind the spinal column can
lumen o f the trachcaltubc. In comparison to the blood also be OOscrve d in the background of ribs and thoracic
vessels that run in the cervical area the trachea has a venebrae. When the thorax i.. examined by longitudinal
much wider diameter. This is particularly evident on sections its image is obscured by pamllel shadows (Fig.
transverse sections through the neck which show the 2. 143). This applies for horizontal sections with latera--
wide, hypocchoic tracheal pipe in about the middle of lateral and sections with sagittal. dorsoventral beam
the neck just ventral to the spine. In the region of the directions. The distances between shadows correspond
head-neck junction the \arymc can be secn (Fig. 2. 141 ). to the widths of the intercostal spaces. In advanced
Occ.1Sionally. swallowing movements can be observed pregnancy the increased ubsorption of sound waves by
he re. On horizonllli sections the common carotid artery the bones can scriously restrict the examination of
can occasionlilly be traced o n either side o f the trachea organs lying behind the ribs. Under such circumstances
and lal)'TlX. Ils pronounced pulsation is slriking. it is possible to rotate the probe through 90 degree. thus
allowing the examination of the thoracic contents
through the intercostal spaces without any interference
2.4.1.4 Thorax from the rib shadov.-s.
The ribs can be differentiated almost at the same The sternum docs not produce the image of a single.
lime as the vertebrae. The nbs. thoracic \'cnebrae and coherent bone. but consists of a single row of discs (Fig.
2.139).
sternum are all charactcnzcd by hyperrcncaivc cross

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158 Ulfrosonogroplly ill file cow

Fig. 2.144: Ven trodorsal sagittal section through a fetus on Fig. 2.145: Horizontal section through the thor-.ax and abdo-
Day 91 of pregna ncy. 11Jc lied; is on the right. 1·leart cham- men of the fetus depicted in Fig. 2.143. The fet us is stilll)ing
bers ( H) and the aorta which runs \'entrally of Ihe vertebral in the same position on its Icrt side. The heart (H) is on the
column (VC) in a caudal direction can be identifIed. left. Caudally to the dorsaUy positioned nbs is the liver (L)
.....ith severnl vessel cross sections. Cranially to the Ir.'er is the
diaphragm (a rl'OO"S) and below it is the slom<l(;h (S).

rig. 2.146: em;.,<; So..--ction through the omasum with its charac- fig. 2.147: Left parnmedian section through the stomach of a
teristic folds (afTOYo'S ) in a fe tus on Day 157 of pregnancy. fe llls on Day 166 of pregnancy. The stomach contains snO\ll)"
renections which. during IongerobscMllion periods. will show
obvious. turbulent mOllemcnts. 1llc dorsal and ventral sacs of
the rumen communicate through the ostium intraruminalc
(Oi).

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BOL,jneJews 159

The cmnial. apical sector of the thordcic cone is ultrasonically visible sho rtly later than the heart and at
filled by the heart (Fig. 2.143 to 2. 145). The laner is about the same lime (around Day 40 of pregnancy) as
very striking with L<; obvious pul'lation, its hypocchoic the developing eyes. It constitute.<; the la rg~t anechoic
heart chambers which are surrounded by the echoic are;1 in the abdome n of the fetus, produces the typical
myocardial walls and sulxlivided by the bright septa and image of a fluid fill ed, hollow organ and permits the
valvcs. The pulsation is clearly noticeable by the move- idenlifiClltion of its typic-dl shape and different anatom-
ments of the valvcs. In order to obtain a favorable ical regions (Fig. 2.146 and 2.147). As pregnancy
image of the heart it is advisable to rotnte the sound progresses, the echogenicity of the stomllch's contents
plane far enough until a window is found between the will increase. At about Month 5 of pregnancy there will
ribs that allows the sonographic examination to be per- be alrellCiy obvious cchogenicity in the stomach. These
formed without the interference of any rib shadows. will become more intense as time p..,sses. Sometimes
This may be difficult and e m oc achieved if the fetus lies they will even develop into snow storm like reflections.
in the optimal position of having its front limbs in close If the stomach can then be observed over time o ne will
proximity to the transducer. If the transducer can be often be able to observe turbulence within its flu id con-
positioned favorably it is sometimes J)()s.'~ible to produce tents.
a 4-chamocr section through the heart (Fig. 2.144). The position of the slQm:lch ClIO give an indicatio n of
When an image of 2 or more chambers C'.m oc gener- the posture of the fetus. If the rumen lies dot"S..,lIy next
ated the functioning of the heart and its larger valves to the transducer the fetus will be lying on its right side;
can be observed. By choosing the correct section if the fetus lies on its left side the rumen will be on the
through the thonuc one can see the blood vessels leaving side furthest from the transducer (Fig. 2. 145 and
the heart. 2.152). The description of the position of the fetus rela-
The space octween the heart and the diaphragm is tive to that of the dam then depends on its prescntation.
filled by the echo of the lung. The lung echo is comscly In the case of a cranial presentation with the rumen
granular, very similar to that of the liver. The dia- found dorsally the fetus is in II left lateral position;
phragm itself cannot be illustrated sonographically. Its where the presentation is caudal with the rumen still
position can, however, oc determined by subtle dif- found dorsally the felUS is in a right lateral position. The
ferences in the echogenicity octween liver and lung same contrasts between presentatio n rInd position arc
(Fig. 2.143 and 2.1 45). valid for the vcntf'<ll1y situated rumen, I.n this case the
eranilll and caudal presentations imply a right and left
lateml position. respectively.
2.4.1.5 Abdomen In a median section through the fetus the abdominal
aorta is scen as a hypocchoic band running just under-
The developing stomach and the liver can oc seen in
neath the many bright echoes of the spinal column (Fig.
the background of the last few ribs (Fig. 2.1 45). The 2.144). When OOscrvation periods over time are possi-
liver can be recognized by its coarsely granular echo ble the aorta's pulsation can be seen. The wall of the
which is traversed by scvcmllarge vessels in the center. \'CSSCI is hypercchoic.
The sonographically obvious stomach lies octween the
liver and the contralateral ribs. The stomach become.<;

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160 UltrtlsonogrtJp/,y in fhe cow

Fig. 2.148: Scctionlh rough the kidney of a fetllS on Day 196 0f Fi&. 2.14\1: DofSO\·cntr.Jltransverse section through the region
pregnancy. Se"cr.d rcnallobcs with conical and medullary re- of the lumba r \'Crtebrole on Day 166 of pregnancy. Dorsally a
gions are visible. lumbar vcrtebra (L) with both transveI'SC processes. Above
thc lalle r Ihe two Mm. Iongisliimi. Below them: Left kidney
(lk). right kidney (r\::) and in bcrv.'Ccn Ihose Ihe caudal ca\~.11
vein and the abdominal aorta.

F!g. 2.150: Tr.lIlS':erse section through the caudal abdomen of Fig. 2.15: Tr.lItS\·crse section through lhe caudal abdomen of
a fetus on Day 62 of pregnancy. The fe lus lies on its side and a retu.~ on o-oly 86 of pregnan<.),. The scanning plane is lilted
is sunou ndcd by ils amnion (A). 111e two Clud'li limbs point slightly 10 run from caudodo~l to auniovl;ntrnl. The urinary
to the righl. Bet"'C en the limbs is the small. anechoic urinary bladder (U)with ilS dar\:: lumen and cchoicW'.dl lics in the cen-
bladder. ter. To the left of the bladder arc pelvic bones (arrow).

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BOl'ille fews 16 1

The kidncys can also be dcpictcd ultrasonographi- urinary bladder is somctimes difficult - /"'VCn with a wcll
cally. In the horizontal section they can be seen between exposed pelvis. Although it is sometimes visible at an
thc iliac bonc and thc last rib (Fig. 2.148). In a trans- carly stage of pregnancy (Fig. 2.150), its accurate iden-
verse section with the beam directcd dOJ'SO\'Cntr.tlly thcy tiflCation may pfO\.'C vcry difficult. The degree of filling
can be found at thc level of the lumbar \'Crtcbrae. im- of the bladder appears to vary. Thc urinary bladder pre-
mcdiately vcntral and latcral to thc spinc. With thc sents with its anechoic, nuid filled lumcn and lies in thc
transducer skillfully positioned. both kidncys can be midlinc of the vcntral abdomen. just lit the pclvic inlet
shown on thc same imagc (Fig. 2.149). Thcy are rela- (Fig. 2.151). On cithcr sidc of the bladder thc umbilical
tively hypocchoic and prescnt thcir typical anatomical artcrics which run in the direction of the umbiliC\L~. can
structure. including multiple papilla dividcd by dcep fis- be found. These can be relatively thick and must be dif-
sures. Bettcr than in thc tr.tnsversc section, the longitu- fcrentiatcd from the urinary blllddcr. The difficulty in
dinal section permits the identification of numerous re- fi nding the fe tal urinary bladder by ultrasonography
nal lobes which collectively fonn the kidney. On each of may be caused by presumed ability of the fetus to regu-
the renallobcs a more hypercchoic outer cortical and a larly empty the bladder from an early stagc of pregnan-
less echoic central medullary region can be recognized. cy on. Shortly after urination it may thus be ,"cry difficult
The next smallcr organ with an anechoic lumen be- to recognize the fe lal bladdcr.
side the stomach is thc urinary bladder. Finding thc

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162 UllrtlSOllogmph)' ill tlte COli'

"i g. 2.152: Horizontal section through the thora)!.


abdomen and pelviS of Il fetus on [)oJ)' 95 of preg-
nancy. 111e :Ipc.'( of the thor.u: points to'l'o'llrds 8
o·clock. the ... tomach (5) lies vCnlr:llly. 111e IWO
halvcs of the bony pehi... with hypcrechoic ischial
and ileal bones (atr(JYo'S). form a cone, the apex of
y,hich is directed 10000Irds 2o·clock.

Fig. 2. 153: Oblique hori7.ontal section through the pelvis of II


fetus OIl Day 21 1 of pregnancy. The cunnection between the
ileal (0 il) and ischial (0 isch) bones. in the! area of the ace-
tabulum. is not yet ossiflCd. Ultrasou nd penetrates thi~ point
(arrow).

Fig. 2.154: Tangential sagiltal section th rough the fronllimh


of II fe tus on Day 75 of pregnancy. 'Ine back of the fetus lies
vcntrnlly lind the head on the right (of( the image). The front
leg ..... ith scapula (5). humerus (H), radius lind ulna ( RU) and
metacarpus (M) is visible.

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BOI'ine/erus 163

2.4.1.6 Pelvis 2.4.1.7 Front limb


During e:trly pregnancy bolh halves of the bony pel- The sonographic visualization of the extremit ies is
vis can be depictcd simultaneously on a horizontal sec- based on the depiction of their bony and cart ilaginous
tion (Fig. 2.152). On each side the ilium and ischium components. Due to the large difference in impedance
can be seen. They prescnt as four rod shaped, hyper- between bony tissue and the surrounding soft tissues the
echoic structures. In horizontal section the ischium is former :Ire easy to recognize by their intensive reflec-
slightly shorter than the ilium. The 2 bones lie one be- tions.
hind the other, parallel to the longitudinal axis of the On the front limb the larger long bones, such as hu-
body and form , with their wunte rparts on the othcr merus. radius, ulna and met:lC<!rpus C<!n be identified
side, the blunted wne shape of the bony pelvis. The lal- for the lir.;t time around .....eeks 10 to 12 of pregnancy
ter na~ slightly towards its caudal opening. When (Fig. 2.1 54). At this stage the ()S';ification proccs.s has
thc ultmsound beam is directed [atero-laterally, the de- obviously progressed far enough to produce continuous,
monstration of both halves of the pelvis is only possible rod shaped echoes in the regions of the diaphyses. After
in the first half of pregnancy. Thereafter, the nearer h:M this time the length measurements of the bones are
of the bony pelvis absorbs so much ultrasound that the taken bern'cen the rn'O ends of their hypcrechoic
other half cannot be seen (Fig. 2.153). At this stage on- diaphyses. Prior to this the measurements are 1:lken
ly the ilium and ischium nearest to the transducer can from the edge of each limb segme nt to its point of an-
still be depicted. gulation. They therefore refl ect not only the length of
The pelvic region can be recognized tQWard.. thc end the main bone. but include the joint and soft tissue com-
of the second month of pregnancy when its ()S';ification ponents of each segment. At the end of the 4th month
centers become visible. The iliac and ischiac bones can of pregnancy il is still possible 10 depict the full thick-
then be seen as individual structures around week 11 to ness of the long bones of the front limb. Due to the ad-
12 of pregnancy. The bones of the pclvis are well suited vanced perichondrial ossification at about Month 5 it i.~
to aid the search fo r the ge nitalia, the urinary bladder only possible to see those sides of the bone cortex of the
and the hind limb. humcrus. radius and ulna ...... well as melacarpus and
phalanxes that are nearest to the tr..msduccr (Fig.
2.155). The sound reflcction from. and absorption on
Ihe compact bone arc so strong that the background is
no longer accc.'>Sible. It rentains black.

Fig. 2. 15S: Sagittal section through a front fOOl on Day 135 of


pregnaocy. The a",ices of the metacarpus (M). proximal (I).
middle (2) and distal (3) phalanl:cs are so we ll 05SiflCd that on-
ly the foregroun d is visible. The two C:lRil:lginous epiphyses
(E) of the metacarpus can be seen clearly.

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164 Ultmsollogm/Jhy ill the caw

t-ig.2.1~ : Transverse section through the front foot of a fctu~ on Day 91


of pregnancy. The 1\\00 hypcrcchoic claws (C) point to the left. To the righ t
of the cl;IY.'S an.: the two bright spotS of the d ..:wcla ....'S. Thc front limb is
epicted up to ils carpal joint.

t-ig. 2. 157: Palma r \;cw of the cla ....'S of bot h front feet in a fe-
tus on Day 164 of prcgn:mcy. [n Ihe centers oflhe cla .....s (le) of
the [eft fool [ie the hypc n:choic digital bones. " b e image of
the right claws (rc) sho.....s o nly the hoo\'cs,

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HOI';ne JelIIs 165

Apart from the bony parts, the horny parts at the tip 2.4.1.8 Hind limb
of the extremities can also be shown. Main and dew-
claws can be seen (Fig. 2. 156). The horny wnll of the The chronological order in which the bones of the
main hooves can be recognized from Month 4 (Fig. hind limb can be depicted are very similar to that seen
2.157). Its echogenicity increases over the following in the front limb. Although individUll1 ossifiC<ltion cen-
months and the hoof wall as well as distal phalangeal ters can be detected by Day 60, specific long bones such
Ixme can be identified. as femur, tibia and metatarsus can only be identified re-
liably stnning Week 10 of pregnancy. A few weeks laler
the entire thickness of the diaphysis of the bone can be
illustrated (Fig. 2.158). The diaphyses of the femur,
tibia and metatarsus produce very bright ecOOcs, Dur-
ing Month 5the ossification is so pronounced that only
those walis of the diaphyses that arc neaTeSt to the
transducer can be depided (Fig. 2.1 59).

FIg. 2. 158: Pl anlodorsal sagi ttal section through the hind limb Fig. 2.159: longitudinal scdion through the me latan.us (M)
of a fetus on Day 11 0 of pregnancy. The !I1!'S:l1 joinllics on lop of a fetus on Day 171 of pregnancy. One side of the bony
and is ncxcd. The bright diaph)'Sis of the metatarsus (M ) diaph)'Sis produces a hypcrcchoic rencction. Distal 10 Ihe
poinl5 to 8 o'clock. the tibia 10 5 o'clock. diaphysis lies a cunilugi nous epiphysis (al1'O\\·). nlere arc two
pl3<'l.'nlomcs (P) in the right half of the picture.

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166 Ultrosollogrophy ill Ihe COli'

t-"ill. 1.160: Uterus ..... ith fetus in il5 amnion (Al on D".lY 63 of FIg. 2.161 : Tl'llnsversc section through the umbiticusof a fC 111S
pregnancy. The umbilical cord (U) runs dor...111y from the fe- on Day J 10 of pregnancy. The 4 lumina of the umbilical ar-
tUS 10 the :lnlimcsomctriaJ edb'C of the uterus. teries !lnd veins C'oin be recognized.

~lg. 2.162: Longitudinal Sl.'CIion through the ino;cnion of the 1-11=..2. 163: The hypocchoic allantoic nuid (AI) lind the $I\O'oOoy
umbilic<LI cord (al'fO'llo) in a fetus on 1)001), 110 of pregnanc),. amniOlic nuid (Am) nrc separated by the llmniotic membrane.
The hypocehoic lumina of ""IQ umbilicll \·cs..<iels arc scp..mLted Inside the amniotic nuid lie the left (k) and right (re) cial'.'Sof
by thc vessel \\11US. a felLlS 011 Day 206 of pregnancy. I'almanricw.

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BMine fellls 167

2.4.1.9 Umbilical cord, amnion and allantois runs tangentially through the umbilical cord one will not
necessarily see a vcsscl lumen. In this case the umbilical
The umbilical cord can be seen early on the uhra- cord appears solid and may be confused with the more
sound monitor. At the time when the outline of the em- caudally situated scrotum.
bryo becomes visible and the head and neck can be dif- The amnion can be recognized as a very thin hyper-
ferentiated the umbilical cord can also be identified. It echoic membrane by Day 30 of pregnancy (see Chapter
runs from the embryo in a dorsal direction to the site of 2.3.2.4). Without signifiC<lOtly changing its thickness it
its division at the antimcsometrial wall of the uterus remains visible until the end of pregnancy. The nuid
(Fig. 2.160). From Month 3 of pregnancy the two um- contained inside the amnion is hypocchoic, almost
bilical arteries and veins can be seen inside the umbilical black, for the first few months of pregnancy. First re-
cord. They are particularly impressive when seen in a nections appear at about the end of the 2nd month of
cross section through the umbilical cord (Fig. 2.161). In pregnancy. They rapidly become denser and soon crc-
this view the four vessels are arranged in a square. ate the image of a snow storm. The echoes become so
Where the umbilical cord enters into the abdomen the intense during the third trimester of pregnancy that the
1....'0 umbilical arteries can be traced caudally in the term "'snow storm appearance" seems justified (Fig.
direction of the urinary bladder. The umbilical vein can 2.163). Echoic particles also appear inside the allantoic
be traced cranially to the liver. nuid during the course of pregnancy.
In a longitudinal section through the umbilical cord
only two vessels can be seen (Fig. 2.162). If the section

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168 U1muOIwgmphy in the co'"

1"". 2.164: Median section th rough a male fe lus allhe level of FIg. 2.165: Section through the snme fetus annlogous to the
the pelvis on Day 92 of pregnancy. The spine stretches from examination plane in Fig, 2. 164, On the \-entml abdomen are
10 o'd ock to 12 o·clock. The scrolu m (arrows) points IOwards the scrotum and genitnll ubc rc1e.
4 o'd od;, Ult rasonogram produced in I'o"dlert)al h.

FIg. 2.166: }-lo07.n ntal section th rough a female felus al the fig. 2.167: Section through the same fetus analogous to the
Ie"el of the mammal)' glands on OilY 101 of pregnancy. Be· scanning plane in Fig. 2.166,
twe<.: n the left (IH) and the right (rH) hi nd ClItre mities tic the
four briglll l'Chocs ort he cross Sl'Clions ofille !Cats (1'). Ult ra·
sonogram prod uced in a wJ!emalh.

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8m 'ille fetla 169

2.4.2 Sex determination in the bovine cchogcnicity the teats become evident as four hyper-
reflective dots which are arranged in a square. They are
fetus best identified on horizontal sections.
2.4.2.1 Scrotum, teats and genital tubercle Another way of detennining the fetal sex is based on
the determination of the relative position of the genital
The scrotum of the male fetus COd.n be depicted by ul- tuberde (Curran et a!. 1989). The genital tubercle will
trasonography (Fig. 2.164 and 2.165). Based on exJX:ri- give rise to the penis and prepuce in the case of malc...
encc to dale it seems possible to detennine fetal sex by and to the vulva and clitoris in the case of fema les.
the detection of the scrotum from the Month 3 of preg- Initially the genital tubercle will be positioned between
nancy. First fcta l se.'( detenninations may be possible the hind legs in both sexes, bUI between the Day 40 and
between Days 50 and 60, but the scrotum cannot, how- 60 of pregnancy it will migrate towards the umbilicus in
ever, be identified with certainty at this stage. After Day male fetuses and tOYo~d.rds the tail root in female fetuses.
60 the scrotum can then be identified more clearly (Fig. The genital tubercle will prescnt as a bilobular. ovoid
2.168 to 2.171). In positive cases the male gender can structure, a few mi11imeters in size and of intense echo-
now be diagnosed with certainty (MOU£R and WITT- genicity. On the basis of the relative position of the gen-
KOWSKI 1986). ital tubercle it becomes possible to predict the fe lal sex
In female fetuses the developing teats can be depiet- [rom about Day 55 of pregnancy.
ed (Fig. 2.166 and 2. 167). As a result of their intense

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170 Ultmsollogmph)' in tile COli'

""Ig. 2. 168: lll1erolllleral UlIflS\'CNC <;Cction through the pel.,is t'4;. 2.169: Trnn!'o'o'Crsc SCCIion through the pel\'js of a fetus on
of II fetllSon Day 860r pregnancy. TIle upper portions ofbolh D"oI)' 99 of pregnant),. The fetm; lies on its back. Bc",,'cen the
hind extremities point to the right. Oc(\\"Cen them lies the scm. t....,o hind limbs (H) the scrotum (5) ~ pointing to\lo'ards 12
tum (s). 111e base of the tail ••m be secn ataboUI 9 o'clock (ar. o·clock.
row).

tlg. l .170: Ilorimntal St.'ClKln distal to the pel\,", through the tlg. 2. 171: Median section through the scrotum of 11 fctus on
knee joinr of a fetus on Day 129 of pregnancy. Inside the Day 170 of pregnancy. The head of the fe tus lay on the right.
tnms'o'erscly imaged scrotum (5) the ""u hypocchoic tcsticular I n.~ide the scrotum the testicle (amw,,') am be St.'Cn. J3clow the
structures can be <;Cen. To the left of the scrotum i~ an 0VIl1 scrotum the umbilical cord (U) with 2 \'C.W!ls can be rcoog.
c:rm.s section through the musclcs of the upper thigh. ni~cd .

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Boville JelIIs I 71

Depending on the position of the fetlL~ and the ori- oping teats appears to be rather difficult during the ear-
entation of the probe the fetal scrotum can be detected ly stages of pregnancy. The teats arc occasionally con-
betv,lcen the hind legs on median, transvelSC or hori- fused with other echoic spots in the region of the pelvis.
zontal sections (Fig. 2.168 to 2.171). The biggest threat Structures often misdiagnosed as teats include the
of misdiagnosing the presence of a scrotum comes from hypcrcchoic images of IransvclSC sections through
structures in the vicinity of the scrotum. In this context pelvic bones or the femur. The determination of fetal
the umbilical cord and any parts of the tail that may sex using the position of the genital tubercle appears to
have been drawn in between the hind limbs should be yield more aCCUT',lIe results in the female fetus.
mentioned first. In order to avoid confusing the scrotum The period from 55 to 60 days of pregnancy scem~ to
with the base of the umbilical cord, attempl~ should be particularly well suited for the determination of the
always be made to demonstrate, apart from the suspect· position of the genital tubercle, and thus the sex of the
ed scrotum, the umbilical cord. Only if the COUISC of the fetus (CuRRAN et al. 1989). If the sex is to be deter-
umbilical cord can be followed all the way to its origin mined by detecting the scrotum or the teats the period
on the abdominal wall, and if, in addition, to it the scr0- between Days 70 and 120 seems to be better suited for
tum can be identilled as a separate structure a definitive the examination. If both criteria, position of the genital
diagnosis can be made. tubercle as well as the depiction of either scrotum or
From Month 4 of pregnancy ult rasonogram~ may re· teal~, arc used in conjunction a relatively high accuracy
veal testicular structures inside the scrotum (Fig. 2.171) in the determination of the sex of the fetus can be at-
which are less echoic than the scrotum proper. Testicu- tained between Days 55 and 120 (WIDEMAN et al.
lar descent starts during the 3rd month in the bovine fe- 1989). It must be emphasized that much opemtor expe-
tus and is completed in the 5th month of pregnancy rience is needed, and that the sex of the fetus cannot be
( H UWNGER and WENSING 1985, Sctl UMMER and determined in every ca.<;c during a single sonogmphic
VOU..MERIIAUS 1987). examination. Occasionally, only follow-up examination.~
According to experiences made thus far the positive allow the sex of the fetus to be determined accurately.
recognition of the female sex by depicting the devel-

AVKlrSKO zasl!l e'lO gradivo


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172 Ultrasonography in the cow

100 B '" Head


'" Thora",
accessible
accessible
90 iii '" Abdomen accessible
• '" Pelvis accessible
80
70
60
% 50
40
30
20
10
0
2 3 4 5 6 7 8 9 10
Months of pregnancy
t1g. 2.172: Frequency with which re tal body parts we re :lCCe$J.blc by transrcctal ul tr.1·
sonogrnphy during pregnancy in hcifel5 (adapted from Kti hn 1989 b).

100
o = Anterior presentation
• • Posterior presentation
90 • '" Transverse presentation
80
70
60
% 50
40
30
20
10
0
2 3 4 5 6 7 8 9 10
Months of pregnancy
tlg. 2.173: The intm-u teri ne presentations of bovine fetuses during pregnancy (adapt-
ed rrom Kahn 1989 b).

AvlorSKO zas!!: eno gradivo


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2.4.3 Accessibility of bovine fetuses thorax, abdomen and pelvis could still be depicted in
one half of the cases. In these cases the cardiac activity
fo r transrecta] sonograpby and their
could also be demonstrated ultrasonically. The trunk of
intra-uterine presentations during the fetuses could only be seen in 25 % of C-dSCS in the 6th
pregnancy and 7th months of pregnancy and was only visible in
isolated ("uses from the 8th month. The head was the
2.4.3.1 Accessibility of fetal body parts body component that could be depicted in 87 % of
uhrasonograms during the entire length of pregnancy.
The specific intra-uterine positioning of the fetus
If certain body parts are reachable by transrectal so-
during the course of pregnancy has a direct effect on the
nography their prominent organs can also be examined
ability 10 depict fetal body parts by ultrasonography.
and sUI"-'Cyed regularly on the ultrasound monitor.
This means that the accessibility of certain structures is
limited by the typical intra-uterine presentations of the
fetus at the different stages of pregnancy and by their 2.4.3.2 Fetal intra·uterine presentations
growth rales. Duc to these factors. for example. the
scrotum and developing teats, the thoracic and lumbar The frequency with which the various body parts of
vertebrae. the ribs. the size of the stomach or the length bovine fet uses can be reached by sonography is signifi-
of the limb bones often cannot be accessed for sonogra- cantly determined by their position within the dam's
phic fetometry during the last trimester of pregnancy. uterus. Until the end of the fourth month anterior and
During onc study the fetuses of 19 pregnant cows posterior presentations of the fetus occur with equal fre-
were ultrasonically examined 485 times at intervals of a quency (Fig. 2.173). From Month 5 the antcrior pre-
few days from the 2nd to the 10th months ofprcgnancy sentations occur more frequently. BcI....'Ccn the fifth and
(KAliN 1989 b). During the second mOnlh of pregnancy sc\'enlh months of pregnancy about 25 % of fetuses are
the enlire fetllS could be depicted regularly at every ex- still in posterior presentation. The final positioning inlo
amination (Fig. 2.172). In the third month the head, an anlerior prcscnlation appears 10 be achiC\'Cd pre-
thorax, abdomen and pelvis were within reach of the dominanlly during the transition fro m the 7th to the 8th
penetration depth of the ultrasound waves in 95 % of month, by Days 220 of pregnancy. Thereafter posterior
« 'ses. During the following months the accessibility of presentation can only be observed in isolated cases
the individual body parts decreased. In MOnlh 5 the

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174 U/rrasollogroplly in Ihe cow

FiK- 2.174: Example of measuring the largest diame ter of the FIg. 2.175: Example of measuring the largest diameters of the
eye. Sagittal section through the skull of a fetus on Day 157 of cerebral Cfllni um and Ihe eye. 5.1gillal section through the
pregnancy. skull of a fe lllSon Day 141 ofprcgnancy.

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BOI'ine fetus 175

2.4.4 Sonographic fetometry in cattle that transverse, sagittal and horizontal sections, as .....ell
as transitional sections between these. may end up
The size and stage of development of a bovine fetus being chosen for assessment. In order 10 obtain thc
C'.m be determined in vivo by using intm·uterine sono- highest possible degree of accuracy the largest diu meter
graphic survey, that is ultrasonic fetometry (WUITE et should be measured between the two furthcst removed
at 1985. KAliN 1989 b). There are nUmefOlL'i useful ap- points on the border between the anechoic eyeball und
plicltions of fetometry in vctcrinary practice. Wherc the hypcrcchoic, surrounding orbit in all ca-;cs. The
disturbances set in during a pregnancy the extent of largest diameter increases from around 4 mm on Day
their affect on the fctus can be assessed by felal sono- 60. 10 10 mm on Day 90 and to 30 mm at the end of
graphy. Whcre doubts exist with regard to thc limc of pregnancy (Fig. 2.187 and Tab. 2.1).
impregnation in pregnant ~ fetal sonographic Apart from the eye Ihe cranial cavity is another
measurements can be used to establish the real age of structure of the head that is easy to find and to identify.
the calf with reasonable accuracy. It is thus ....'CII suited for fetometric assessment. The
In order to obtain concJtL';ive results it i~ important to bones of the roof of the skull and the bas:.ll parts of the
conduct the fetometrie survey as precisely as possible. cranium form an oval shape which surrounds the brain
Before uny mcasurenlcnts of any fetal p<IMS arc tuken and is sharply contmstcd against the hypocchoic bmin
the probe should be rOiated and swiveled gcntly until cortex. lllis clear border is used for the determinntion
the largest possible section of the organ is depicted on of the largest inner diametcr of the cranial cavity (Fig.
the monitor. Measurements of all sizes are taken ahng 2. 175). The largcst distance between the outer surfaces
a straight line between IWO points. In this manner, for of the cranial bones is seen as the oUler diametcr of the
example. the crown-rump-Iength (CRL) is determined brain cavity. The cranial cavity can be biomctrically
along the direct linc berv.'Cen the crown and the &hi· evaluated until the end of the 7th month of pregnancy.
urn, and not along the curvature of the neck und back. During the last two months of pregnancy so much ultra-
sound is absorbed by the bones oflhe cranial roof that it
becomes impossible to depict a complcte section
2.4.4.1 Eye and braincase through thc cranial cavity and thus to obtain its largest
diameter, On Day 60 the largcst inner diameter of the
The eye is the organ that is most frequently av-.Iilable cranial cavity is 10 mm and the largest outer diameter is
for fetometry by transrectal sonography during all 17 mm on average (Fig. 2.188 and Tab. 2.1). Both
stages of pregnancy. By optimally positioning the ultra· pamJ1leters increase linearly O\'Cr the following months
sound probe a section which sh<Jl.\'S the largest diameter to reach 63 to 76 mm and 80 to 96 mm. respcctr.'Cly.
of the eye should be obtained (Fig. 2.174 and 2.175). In during the seventh month of pregnancy.
doing so it is not alw.l)'S possible to determine the exact
direction of the section through the organ. This means

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176 UllJ1JSO<\QjJTUphyinlhecow
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(0/"mrn) 0,97 104


BraiOlCMeinlaDal (w-) , ,, -16.18+0..433 . (61-1'16) 0.96 W!I
ero..... fIIIIIP"len~(lenJIMnm)y.-IO'76 .. 0,0199 . 1 (11-&3) 0,')9107
E,e (Wmm) y,, -13,20.0.31', (110-268) 0.91249
_Q.OOCl6I.1
(l<n&lMmnl,,,-0.1 •• 0.001f7.2 (6I}-20 1) 0.99 108
(\>eIl>IraioI} ,_1,».96.0.609, (60- ~2) 0.70 261
• O.ooISl ,1
(~)J " -1.~.0,OOI9J.2 (6I}- 19j ) 0.96 78
(Iao&IMmIly ,,- U)+o.ooIM.2 (~217) 0.98 108
(Ionzthlmrn)y._O.Sl+O.ool(l6,l (61_1110) 0.96 Sol
(~J._0.IW .. o.ooj)5,l(6'_201) 0,9S"
(!ms<Mom)y •• o.OOW.0.OOU19.2(60-111) 0.97 50
(Ic>&IMnm)y,,_j,32+0,OOIB1.2 (63-206) 0,96 toJ
(0frnm,) y .. - S.21:" 0.Hl'l. (61 -2011) 0.96189
(\eI>JIMnrn) Y" _2.1 1+0,00215 , 2 (63--201) 0.97 M
(Wmm) y. ·7.7&.0.191. (61-211) 0 .92 S)
~) , . -29_1O.0.62:h (60-211) 0.961Sl
(l<r\a!Mm1)y . -1.01.0.00108.2 (63-201) 0.98 56
(WmnI) y .. -U7 + 0.06.'i. (17·2.S2) O.BI S8
(WmmJ , •• U.II.o.~~ . (1l-l63) 0.97 ISS

(WmnI)
(Wmm)
(Wmm)
' "
p
+O.lXlln. 2
2.2. + 0.00121. 2 (60-206)
- 5.1l+0, 14h
y o. ·6,49 .. 0.099.
(6I}-201)
(M-20I)
...
0.97 223
0,9)
~
150'
,,, - 5..40 .0.106. (61.246) 0.9' 137
, ,, -'.15+0.099. (1Ia-191) 0 .99 7
, . . . . . . . . Q.(9). (62-U2) 0 .91 II
y . -3.$) +0,08 I, (&4-211) 0 .9l 21

T. b.l. l: R .I. liuBSlup> {~~)"'ftt:dSl""'..ml<>tbe.or~_

Days of preg nancy


~1!:.1_ 1 7': Thehe'"noI.oIl><Mfteln_durin&~(~.-..Iut>and
",~"", .. )

by Dr.Stator & Saraajka


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/WI'ille Jews 177

2.4.4.2 Heart frequency, crown-rump-Iength, em. The CRL (measured betwec n the occipital tx.lOe
diameters of stomach, trunk, scrotum and and the first vertebra of the tail) reltches 12 em IOwards
umbilical cord the end of the third month of pregnancy (Fig. 2. 187 and
Tab. 2.1). The daily increase in CRL is about J.4 mm at
The movements of the heart can fi rst be seen very the beginning of the second month and increases to 2.5
early at the end of the fi rst month of pregnancy. Due to to 3 mm during the third month. The determination of
the relative ease with which the thorax can be: depicted the CRL is one of the most accurme me:msof deciding
through the following few months the cardiac action can on the age of a fetus (HACKEt.oER. J984, WtllTE et al.
be monito red without much difficulty (sec Chapter 1985).
2.4.1.4 and Fig. 2.1 81). In fetuses which lie in anterior The anechoic lumen of the stomach com be reliably
presentation the heart can often be monitored even recognizcd and surveye d tow.lrds the end of the second
during the last month of pregnancy. mo nth of pregnancy (Fig. 2.177, 2.187 ,md Tab. 2.1). At
The heart (,.Ite of young fetuses is very high . occa- this time the largest diameter orthe stomach lies around
sionally reaching a value of 180 to 204 bealS per minute 8 mm. It increases linearly during the following months.
during the third month of pregnancy (CURRAN el a1. The stomach can regularly be: depicted in its totality lmd
1986 b). The mean heart rate decreases as pregnancy its diameter determined until the sixth month, there-
progresses and lies around 160 beats per minute at Day after only in individual cases.
60. 150 around Day 90 and 130 to 140 between the fifth The scrotum can also be evaluated fe to metrically.
and ninth months of pregnancy (Fig. 2. 176 and Tab. From Day 60 it fo rms an echoic struct ure which projects
2. 1). Generally. the variations in the heart rate arc con- from the abdominal \\'311. The scrotal width can be de-
siderable. In fetuses examined repeatedly at wcckly in- tennined on a traOS\'ersc section through the pelvic re-
tervals it was possible, in many of them. to detect signif- gion. From the founh month of pregnancy an exact
icantly different heart rates at successive examination transverse section through the scrotum can be recog-
times. nized on the basis that both testes are depicted next 10
The crown-rump-Iength (CRL) of bovine fetuses c.1n eaeh other (Fig. 2.178). The largest width of the scr0-
o nly be detennined over a relatively shon period. Due tum increases linearly until the seventh month of preg-
10 the limited size of the image of most ultrasound scan- nancy and reaches an ;!verage of 30 mOl (Fig. 2.188 and
ners it is hardly ever possible to still depict fetuses in Tab. 2. 1).
toto o nce they have reached a length of more than 10

Fl«. Measuring the largest diameter or the stomach.


2.177: Fig. 2.178: Measuring the ....idth of the scrotum. Tr.. m....·ersc
Horizontal SCCIion th rough thi! abdomen of a retus on Day section through the pcl\,M::: region of a fetus o n Day lS I or
107 or pregnancy. pregnancy.

e 10 ;JradlVo
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178 UllrtJSOllography ill Ihe cow

."Ig. 2.1 79: MClL'ruring the trunk diamete r on a tmnsversc sec- Fig. 2.180: Measuring the largest tru nk diamete r on a trans-
tion through the atxlomcn of a k lllll on Day 81 of pregnancy. vcrsc section through a fetus on Day 62 of pregnancy. The rer·
At abou t I I o'clock is the anechoic stomach and at 2 o'clock a viel! spine and the cone shaped thard;( are hypcrcchoic.
cross section through the umbilical cort!.

Fig. 2,181 : Example of observing the pulsating heart in the tlg. 2.182: Measuring the length of 6 lumbar vcrtebme and
apex of the thomx as well as ITlCllllUring the length of 4 ribs and their associated intervcrtebrul spaces. Horizontal St.'CIion
their associa ted intercostal sp.'K'CS. Horizontal SCC1ion through th rough the thorax lind abdomen ofa felU.~ on Day920f preg·
the thord;( of a fetus o n Day 166 of pregnancy. nancy. Ult rasonogram of an excised fetus in a ....'3terbiilh.

~---------------------------------------------- .
Avr S 0 zascnc 10 ;JradlVo
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Mea,ure"...,n"of lhelrun\:shouldhelakenal iI' 1I1Ira<ou nd<o;;anne"'-TIleirhordersarealsonOlclcarly


. Slpoint, inlheregionof(ilC la<.lrib<\.atlheb<:lof (icrnaTCalcd and. paTli.:ularly duringcariy pregnancy.
livcTandSlomach.ForthispuIpObCatmn""rscscc- tocywrrcspondto lhebone,'ossifocalion""ntersTalhcr
throughlhe abdornen ,hould be oblai ned ( Fig. IhanlO lheiractualoullines.
179). fly examining a scction rtlflo ingvcrtical to tne Howe,,,r. il is p<.lS'ihle 10 measure thc length of a
al ",alb it is JlOS'ible to obtain a rounci m"" ",holesecrion oflhevertebraJrolumnwl1 ich includes
ion through the lrunk. Longitud inal 'lection, severalvertebrae(F'ig. 2.182). Thl:$wou ldlheO)'icldlhc
ghlhemiddlcofrhcrnlflk inlhcfonnofsagil1al "umbcrOfvcrtcbmc pcr unillength , from Ihis pammc-
horiwnml Sl....1ions can also be c''''dlu'dl~d (Fig. Icrthenumhcrofvertebraeina particularseCiion os
!KJ),lnlhesecase'lheheighlOft helru nk oril!;widlh ",,,11a'lheirindivid,... l sUcandlhatoflhcintcTYcncbral
Iongiludinal!oCC1ionsoorrcspomlswilSdiaJJli:ler in sp;=canbe<lcdoctcd , Forlhi'purposcme"'lIreasec-
'rsc sox1io", al the samc place. For=ralc tion of the ""nebral column a, long"' p"",ihle and
rement, il is importarll 10 produ"" a Iran"",,,,,, dr.ide il,1cngthhylnenumocrof,'crtchmcindu<kd
orie nledexactly9()"rothelongiludinal axisof During the s.;-oond half ofprcgnml<.Y lhis measuremenl
bodyor.lrmgilUdinal"""ioncMlt1Jythroughthc "ften indude'< oot more Ihan" to 4 ,,,nehrae on a
cofthebody. Jfthe lr.nwerse"-"'.'1iQnarerolaled 'ingle image . ,,'hereas7Io 8vr:r«:hmc can be secn
yfmm lhe vertical plane towanislnc lo"gi l<,<i i" ,,1 simuhanwusJy01l imagc,lai«:n during the fiThi third of
of lite hoJy ni<JTC 0,",,1 mJSO Sl."<.1ional imab'Oiofthc pregnanq'.
arc c1\:alcd. Th""" result in inaccurale mea,ure A,im ilararproach;'suilahlcfo'JJli:a,uringrih<",-""
I' , 'The .... me is lrue for sagil1al sccliollS Ihat arc <;cc1ion& and inlm.u;tal"""""" (rig. 2.I.sl).A horiwn-
cd from Ihc rn.:dian towurili a paraIIIl...Jian pbnc. laJsc>ctionlhroughlhefetallhoraxis"'qu i",dforlhi.<
On DayW 1o 70 Ihe lrunk diameler of bovine fe- nle""''''menl lntheSlOOJCw"ya&rbc,izcofindividual
measu=bel\\"cn 20 and J.O mm (Fig. 2.187 and vertcbTacwa,dckrmincd. lhe,;"'of,ing\eribcross
1.2).hlhcnincrcascsbyO.9mrnpcrd"ylorca"h =~:I~:dthcircoTTesponding intercostal o;pacescan
mmaround Day 150 ofpregnanq(WlllTEetaJ
). Al thi.poinl il rcadlCSthcsi", Ih~1 cq ualslhe 11l<: ccTY;""lvcTlcbmc arecasicst to reach and are
imum imaging Ikplh and widlh of c'Ilm:nUy usually delectable umil the end of pregnancy. TIle
Ioycd ultrdSOund equipment. Thi' prohibit< Ihe le nglhofonecervicalvcrtchmandilsadjoininginlcr.
plete<iepirtionoflheetllirclrunkdianlClerinlhe ,,,nehral>j=incrcascs{rom2Io4mminthcthird
ingmomhsofpregnan.:y monlhlO2SmminllH:.ighlh IIlO1lth (Fig. 2.1l\7and
TIIC umbilical oord is easy to find in many instance, Tab. 2.1)
ilslarge.'ldiamelercanbcdelermined (Fig.2.161 Thcs~oflhor...ci<:. l umbarandc-dudaJvcn~bmc
Tah. 2.1). Il< wry lort,oou, oour.;e u",aU}'makcsil lic in thc same r.mge (Tab. 2.J).'Theyare,IIO\\""'er,le",
10producc a Irdnsvcrsdyuriented seClion through ea,ilymeasure<iand. byvinueoflheinlra.U\crinep<ll'i-
umbilical cord. lioningofthcfcllL,.lhey.reina=il>lchysonograpny
duringlbcl<lSilhirdofprcgnancy.
TIlesi:reoflherihcrr,.;i\CClion'andlhelrin\cn::0'<tal
<paCCSCOTTI!>j>Ondlolhe lcnglhoflhc,,,nchrncand
locirintcTVCTlcbmlspaccs(Fig.2 ,ISl!andTab,2.l).As
Iooga,thethorax""l il1withinreac;hoflhesoundwa,'eS
It seem, inocrurale 10 take sooographic nlCa'ure_ lheycanhe<kpicted,Mcasuri"glhclcngthofarib is
\J5of indi.;d""lvcTlchmcoroftbccTUS/;"-,,-tloru;,,f imposlilhlc.becauscitssizeusuall).·e:<",e<is lhaloflhe
Ductolhcirinte nseechogenicil)'lhesehonyslruc ultrasound scanner's image. and hecausc of il< CI!I'\'cd
are easily recognizcdal an carly>lagcofprcgn"TI ' sI1ap<:ilcan11OIhepm;ccrcdinasing,k;irnagLngplanc
bulrelalivecnangcsinlh~ir,izc,an.;I"",,,,,,lIlodc·
bc<:auscofthclimiledresolutLonofcon''entional

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180 Uf'rrlsollDgrrlplly ill ,IIe COli'

Fig. 2.183: Measuring the length of the diaphysis of a fetal Fig. 2. 184: Measuring the lengths of the ilium and ischium in
metacarpll~ (M) on a sectIOn through a fore limb showing also a sagillaJ KCtion through the peM!; of a feltlS on Day 189 of
the Ii~. S('COnd and third ph:I!:Ht.\CS (I. 2. 3) on OJ)' 125 of presnan')'.
pregnancy.

t' ig. 2. 185: Mcasllring the length of a femur in a horizontal SCClion through
the pclvic port ion of a fetus on [)oJY 1().l of pregnancy.

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Bm'inc {Cl/IS 181

2.4.4.4 Front and hind limbs The optimal 3pprooeh for the fetomelric age deter-
mination of bovine fetuses depends on the stage of the
The fetometry of the limb bones invol\'CS the meas- pregnancy and on the aCC(...~ibility or the fC lal body
uring of the lengths of their hypcrtthoic regions. These parts. When the head C'oln be re3ched the biomelry of
regions reprcscntthe ossified sections of their diaphyses the C)'C 3nd the skull cavity should tx: ronsidered relia-
(Fig. 2.1 83. 2.185, 2.186). The ossificatK)O centers are ble parameters. The e)'CS lind skull C'olvity coln tx: meas-
characterized by their \'Cry intense reflections. Their ured very accur.ttcly and are usually accessible through-
echoic pans end relatively abruptly at the transitions to out the rourse of the pregnancy. Apan from these there
the canilaginous romponents of the bones. When meas- are numerous suitable body pans thul can be used
uring the length of bones the ultrasound beam should during Ihe first half of pregnancy. The accuracy of the
imp..1ct venically onto the bone. In the front limb the 0s- fetal age estimation can be e nhanced by the rombined
sified pans of the scapula. humerus, mdius and ulna. as assessment of as m3ny mensurements as pos."ible.
well as metacarpus can be evaluated by fetometry. Since
the radius and ulna are dirrlCUlt 10 differentiate ultra-
sonically, their echoes arc usually seen as a single one.
The bonc.o; of the pelvic limb that are available for feto-
metric purposes are the ilium. ischium, femur. tibia and
metatarsus (Fig. 2.184 to 2.186 and Tab. 2.1).
The long bones of front and hind limb have approxi-
mately the same length nnd show similar growth mtes
(Fig. 2. 187, 2. I 88 and Tab. 2.1). The ossified diaphyses
of scapula, humerus, mdius and ulna. metacarpus. fe-
mur, tibia, and metatarsus ha\'C an average length of 12
to 16 mm on Day 90 and grow to 5510 65 mm in length
by Day 180.
Among the bonesofthc front limb the metacarpus is
the easiest to reaeh by ultrasonography and can, in cases
of anterior prcsentnlion. still be depicted in advanced
pregnancy (Fig. 2.183). When the metacarpal bones lie
close to the matemal pelvis. the optimal rotation of the
ultrasound prolx: will often allow them 10 be brought in-
to the optimal plane relative to the sound beam and
thus greatly facilitat e the taking of reliable measure-
ments. Generally, all bones of the from and hind limbs
can be cvalunlcd feto metrically until about the seventh
month of pregnancy. Arter this siage they are too large
to be depicted rompletely on a single ultrasound imagc.

t... 2.IM: Measuring the le ngt h of the diaphysis of the mela·


tarsus in a sc..'CIion through the melacarpus of a fetus on Day
175 of pregnancy.

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182 Ultrasonography in the cow

Estimation of the age of bovine feluses and pregnancy


through sonographic retometry.
120 .........•..........,..... . ..., ......................................................................
,• •
.120

••
CRL •• •• •
SlOmach
100 ......... .......... ...
~ ) ,
•••••>••••••••••>••••••••• .......... ........ . ······ ····,··········)····· 100
•• •
•• •• Trunk •

• ••
••

Tibia
80 -

-
.........•......... .•........ ... ...... ........ .•........
• ........ -:-......... ; ..........•..... 80
~

••
,•
• ••

~elacarpus
... ... ... _........ _....... .... .. ..• ... ..... -:- ......... _.. ....... _.... .

,• ,••
• • • ••

•• ••
,

•• ••
40 .........• ...... .. .•....
~ • ... . • ..... . .. • .
~ ~ ......... .........
~ ~ ................ 40
Eye
••

•• •

20 ........ .,. ..... .., ......... + ........ + ........


••
Cervica vertebrae with
one intervertebral space
o -1- o
o 30 60 90 120 150 180 210 270
Days of pregnancy
Fla. 2.187:Regressions of the gtOY>1h rutes of the CI'O"l1. rump-lcngth (C RL). the largest
diameters of the trunk, ~omat'h and eye, the Icnglhs of tibia a nd metacarpus. aswctl as that
of one cervical Vl: n cbra with its intcIVc rl ebral space in bovine fetuses during pregnancy.

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Bow'fle feills 183

Estimation of the age of bovine fetuses and pregnancy


through sonographic fetometry.
120 .................................................................................................. 120

••
•• ••

100
. .
.... ..... .; .......... ·....................,·................................ .,.... . 100

••• Braincase ••
•••
external ••
•••
80 ........ .......... :.......... :.................... .................... .......... .... ...... ..... 80
\ \ ~

• •
Femur
• • •

• ,

••

Metatarsus
.. \ ........ .. .......... ........................ ..
........ 1·· ........ \ .. • .. · ..................... .
• •
• ,

~

Scrotum

40 ...................................
• ........
••
·.. ···,·1,1 ..........................
40
•• •

Os ischii •


•• •

20 ........ ; ........ .. ............................. ; .......... ; ... .. 20

Fig. 2.188: Regressions of the gn:w.1h rates of the external diameter of the braincase. the
length of the femur, metatarsus and ischiac bone. the cross sectional diameter of the scr0-
tum. as we ll as one rib cross section with its corresponding intercostal space In bovine
fetuses during pregnancy.

Avtorsko zas~ eno C'radi '0


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184 References

References to chapler 2 HUWI'IGEII , R. 1.. IJId C J. G. WaurNO (198S): On till of the R$lb
in the feIPI calf. N:ta anat. 121. 6] 68..
ikf.lANO, 1. J. (t9II7) : Control of follicular,nM"Ih IIId dtYelopmtDl.
J. ~prod . Fen., Suppl. ]4, 39-54.
AI'IDRf..s.EH, P., R. DEHI'lINO lind A. SOII'I ElDEOOIlt (1986): Eln Bcilrq IItf.lAMD. J. J.• D. B. Cout..soM Ind R. L. MUJ.PtOt.EI! (19l9): Follicular
wm (jranuklf" .. lIrumor heim Rind . Pnkt. Ticram 4, 307- 309. dtYelopmem duri", four II,&" 0( ibe eslrDW qcl .. of beef" attle. J.
Bil l ' EltlOOil. K. 1.• M. D. E ....~ HOWl;, O. C B. RANMU and D. Anim. Sci. 49. 1261- 1269.
MI1OI EU. (1980): CoIleo;ti()n, description and IlaIlIkr 0( ~ !UHN. w. (1985): Zur Trtdltigkl:itsdiqnolc: btim Rind minell Ulln-
(l"0III ..anle 10-16 days after oesIrus. J. ~prod . Felt . .59. 2OS_ 216. sehall. Tltrtml. Umseh. 40, ~--<n.
Cll,<.~.....ux, 5., F. V Al.OI'I eI 1. MAlIT1l<l!Z (1982): Evolution de l'iltlolF KAHN. W. (1916) : Vortommtn und VoKhstumIdynamilc __ OtIbk6r·
6c:~ue du produit de (oUCtplion ella Ia Ykbe. Bull . .-\..ad. vtt. pen! mil Hohlnrum v.ifut,nd. des OvuiaIxyklut bei Rindero uro;! dm:n
F,. .5.5, 213-221. HIM II ....lprofile. Dtlch. titrlml . WJchr. 9l, 475-480.
CHio.FIiOUX , S., G. N. S. RIDor , F. VAI..ON and M . THlara (1986) : KAHN. w. (1989 I): Otlt.klJoper mit WId ohne Hohhwum bei Rindem .
nansrecuJ ruJ ·time uluuound k&IUIing for dia&noli,. prqnanr..)' and Ihr 'b"kommen lind ~ Ent...icklq im Zyklut WId wlhR:nd dtr
for monilOringtmbryonic monaI ily in dairy cattle. Anim. ~Plod . Sd. Flilhgrwiditil. Titrirlll. J>ru ., Suppl. 4, 1-6.
Xl. 193-200. KAHN , w. (t989 b): Sonosnphic fdomeuy in the boYine.. 'T"herioJeno-
CHooQo.II"Y , 1. B.• 1. T. Otllt and O. B. M..wAI'I (1968): Cyo;lit thangc:s logy 31, 11OS-1121.
in boooo ine vesicular bll itlcs. 1. Anim. Sci. 'II. 468-"U1. KAHN, w. (1989 c): Die Entwickl""l \'011 FoIlilD::ln beim Rind: \bIn-
C\rUAN , 5., R. A . PiERSON and Q J. Oll,,"U, .. (1986 a): Ultrasooosn- deru.,. ;ru"r AnDh.I und 0TMc: ~nd des OvariaU)'klut. Berl.
phic appearvoce of the boooo ine tonCcplus from ~ KI through 20. J. MOnd! . tittirztl . WIcht. m , 44 49.
Am. ~ . mod . MI. 189, 1289-1294. KAHN, W. (1990): Sonopphit ima&inl; o(tht boYine rewa. Theriop
evu...N"_ 5._ R. A. PiUSON and Q J. GlNIlIllt (1986 b): UllJa$OIIIJin- noIoa.Y )). 385- 396.
phic appeannce 0( the boYine COIoIXplUS from dIys 2Q through 60. J. KAHN, W. und W. LiiIDI.. (I98j): SonoJnphifehe Btfundc am UIeiUl
Am. ~ . mod . All. 189, 129.5-1302 . __ Srulen mil UIIJ"UCbaII bei tiner Fequenz \'011.5 Mephtrtt (MHz).
C\rUAI<, 5.• J. P. KAsru.K: and Q 1. On....HEII (1989) : Dtfennining Pf"ddltiikundt I, 239-2-46-
it1 of the boYine I"e!us ~ ultruonic ...... ·ment of the relative Iocalion KAHI'I_ w. und W. I..EJDr.. (l986) : Die Anwcndung der Ecbognphie Dlr
of the Fnillli lubtrdt. Anim. ~prod. Sci. 19, 20- 227. Oiqnok de. OvarlIInktioa btim Rlro;! . TIttIrUI . Umsell. 41 , 3-12.
Ooea.JNSItl. W. und H. Ka!!NEII (1982): 'krtdliedalc Ancn \'011 8- KAHN", w. und W. t fTDI_ ( t9II7) : E.cho&nPhische Btfundt III Ovarien
Bild.Qcillcn und t inile: ihrcr lCdInistben ~. In: Sonogn- __ StuICll. TieTIm.I . Umsch. 42 , 2.57- 266-
philChc DiaBnmlil< innerer Erkrankungen pp. S--2.5, Hf1,B.: H. Kre- KAHN. W. und W. !..£tDL (19S8): Auswirkunaco tiner HCG-Stimvla-
mer. Vcrlli Urban &: SchwarttnbtiJ. MQnc:ben , W.en , Baltimore. lion bei Rindem mil t inem zystischtn oder einem ~.... p... OtIbk6r-
Ow,NC"OOJT, M. A., 0. AI<DRIEV d W. W. THATCHD (1988): SlIiyi per: PlOieilellM .......'iI.., Ovulalionsinduktion und Aulbilduna t ines 2.
de Ia t roisYntt foIliculaire par 6c:bognp/lit au COUll de qckl nalUrels Oc:lbkOipers. TIe:rlntl. Umseh. 43, 430-4)9.
eI Rimulfs ebel \a YaChe. Reel . M6:I. y~ . £e. Allon 164. IOIJ.-IW. KAHN , W., W. Lao!. und R. R1vo.cOLLFll (1989): Die Kammcrung des
f"tssoI:lI, R . A., A . 1. EDl I:lHD5Off _ R . 1.. PASHa< and R. H . Bot<oo· Rindcruterus wlhrcnd der FrGhBnvidiW. E n IkraJotkh morphoIoJi-
ItANT (1986): The usc ofulUUOOO&T1lp/ly for tht .uudy of !be boYine seher. IOIIOinphischtr lind kemspintomor;np/lildltr" Btfundc. J. vet .
lCptoducUve u.n. n . Non·piqIWIl, piqIWIl and patbolop:al condi- Melt. A 36. 641-652 .
tions of the UIeNS. Anim. Rcp,od . Sd. 12 , 167- m . KAsmJc , 1. P. , S. evu... N, R. A. f>tusoto and Q J. GllmlDl (t98B):
GtNTllEII , Q J. and R. A. PrIlt50N (1984) : Ultruonic llIalOn"ly Ind Ullruonit evalnltion 0( tht bowine COIMXptUS. "Tbc:riotmoIoID 29,
pathok:Igy d !be equine Ulerus. TheriogcliOlOl)' 21_ 5()j-~16. "-".
GINTIl Ilt. Q J., 1.. KNOP'f and I . P. KAsmJc (1989 I ): Temponl asso-- KAsmJc , 1. P.. S. C\rUAN IIId Q J. GINTIlIlt (1989): Alxui1lC)' 0(
eiations amona ovarian eveDl$ in canle durin& oeatl"OWl cycles ...ilh two ultruorqnphy br prtIIIIIIt")' dilposis on dIys KIlO 22 in heifers.
and thrte foI liculat ...aves. 1. ~prod. Fen. 117, 223-230. "J'htrioseooIoI )1 , 110-820.
OINTllEII , Q J.• L. KHoPF IJId J. P. KAsmJc (19119 b): Ovarian follicu- Kno, S.. K. OKIJn,\" K. MIY4' - ' and K. SAm (1986): SlIIdy on the
Lar dynamia in heim durina CIIrly piqf\II1C)'. Bioi. ~prod . 41, appeannce o( ibe cavity in the corpus lultUm 0( COWl ~ nling ultruonic
2.f7- 2.54. IoCIIInilll. Therior;enoJosy 1.5. 31.5- ))),
GJE5DU _ F. (1969): Age dtltrmination 0( bovine fotlU$el. AcIa vel. ! E'Ol , W.. U. i3aAuN, K. O!tlJlM.. R. 5rou.A. WId 0. ScK.uu (r9&3):
Kand . 10. 197- 218. It'I'Ilifitien.na der Ovanytten des Ilinde$.. Wltn. titrtml . Mseht. "Xl,
OItI!E.f<;Sl"VN, I . S. Ind R. C Fot..£y (19.58): Early tmbryology of !be 208-2IJ.
to:M'. I. o.stru La IJId primitive $trtak sugn. J. OIiry Sci. 41. 409-421. MAT1Uf<f , P., V. AOIll.AKOUN, Y. COuTvRe IJId 1. J. D\IJoIn: (1981):
H...:xnw, B.·l . (\98.4): UIU1..d""I · Unle~n 1m I. Tn_r. 0n1wth and ~tll"DI of the boYint O¥arian foI.liclct durina the
In: Die lJltrudlaJldiqnostik in der Sc~lIaft 3. Aun., pp. atroul qcle. J. Anim. Sci. ~2, 110-820.
.f7- .58. HTI,.: H.-I. HoI1inIkr. Ikrlq Urbui &: Sc~'1, MOn- MOUD; , E. and G. WrrT1IDIr"SIU (t986) : VlSU&!inlion 0( 1liiie and
t hen . Wltn. Baltimore. female dwxteristiCI O(bowine ftnuts by n:aI-time ultruonb. Therio-
HANZEN , C. and B. Of' SIj ,X (19117): UK oftnns~ B· mode ulln~ FnoIotY 1.5, ~71 _~14.
iOUnd imagina in boYine pregnancy diagnosis. Ikt. R= 121, 200-202 . Ma UD; , E., D. RATI! , E. K1.oo lind H. MEkKT (1986): Die Anwcnd-
H.... I FI_ D. (1984): Physik lind Teclmik der UllrucMlIdi.q:_ik . In: barktit de, Sonocnpltie xur OiqnosI:ik am weiblichen Otnitale des
Die Ultn.KfuoIld~ik in de. SchMn&<:nchaft 3. Aun .. pp. 3-11. Rinda. Bc:rt. Mandi. titTiml . WadI •. 99, )11 - )18.
Hill.: H.-I. HoIlinder. Vctla& Urban &. Schwal7.tnbt'1_ MOnchtn . NICUl._ R.. A. SOIVMMEII , K.-H. WIU.II und H. WUEl'IS (t984):
Wlen , Ballimore. BeektlllQnel. In: Ldlrbuch der Anatomie de, HlllPiere, Band I. pp.
HouJ.NOD, H.-I. (1984): UnttnudlUngcn im II. lind III. Tn,,-
teT. 13-91 . \bn : R. Nickel. A. Schummcr und E. Seiftrit. 'krta& Plul
Anatomie und Biometric des Fews. In: Dit UllrUChalldi.q:noltik in 1"Ilq. Bc:rtin und HambufJ.
der Schwan&ersdlaft 3. Aun .• pp. .s9--80. HrsB.: H.-1. Hol linder. 'kr- NOOEH , D. M. lind A. De I..AHUHT.. (198S I): Trunk mux~ IJId COII-
I., Urban &: Sehwai7.tnbt'1, Milnchen, Wltn. Baltimore. nmive lillll"'. In : The EmbryoIocy 0( Oorne$ti(: Animal. pp.

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References 185

14O-1S!5. Edl. ; D. M. Nodel! and A. de Lahu.nIa. \l:rl., Williams &. ScHUNNEJ.. A. urwl B. VDU.MEItHAUS (1987) : Hilllen del Hodcns urwl
Wilkins, BlItilDOfe, LoncIorI, Los Angel", Sydney. des Samenstnnp. Ham- und Gc5chlec:hWlppc1ll. In : lzItrbudl der
NQoeI, D. M . and A . 011 LAHWl''' (t98S b) ; Clrdi<Msaitar I)'IRm AnaIOmie der Hausl~re II . 6. Aun ., pp. 33)- ))9. \UI : R. Niekel ,
II: hurt. In; ~ Embf)'oIogy d Domestic Animals pp. 231-2!56. A. Schummcr unci E. Scil'erle. Vcr.., Pau] Parey. Berlin urwI Hamburz.
&15. : D. M . Naden and A. de Lahuma. Veri., Williams &. Wilkins. SlilFaL£. E. (1984): Har1e Him- und RlIctcnmarbhaul. Hallen del
BaJlimooe. Lor,OOil , Los Ancclcs. Sydney. m lrJJncnocnsystcms. ln: I..d!rbuch der Analom~der Hausticre. Band
QK..\f'IO, A . and T. TOMIZUXA (!Il87): Uhruonie obsc~tion d post. IV. pp. m - l14. \UI ; R. Nickel. A . Schununcr urwl E. Scil'erle. Ver-
pattUm uterine imoIUlion in the roN. Thc:rlogenoIosy 27, 369-376. I., Paul Pafty, Berlin urwl Hambu'1.
Ot.::1JlM., K. (1982) : MOijAlVlop.;he unci cnclobinolosiJchc Unlerw· S/JtoIS, 1. and J. E. FoIn'1.It<e (1988): Ovarian follicular d}'lWltics
dtuneen am Corpul IuleUm periodicwn wxI J18¥idltu.is del Riode$. durin& (he ewous c:)'C1e ill heifen rnonilDred. ~ n:aI ·time ultrasonogra·
Vet. mr:d . Diu., MQncha!. phy. Bioi. Ib:pmd . 39. 303-317.
P1asoti', R. A. and a 1. GnmfEJ; (1984 a): UI~ for SrAKIMILLEJ., R. B. and B. G. EHoutID (t982) : FoUiculogcncsb in (he
ddection of presrwq and lIlIdy d cmbr)unk; ~Iop"enl in heilen. borooinc. ThcrioeenolD8Y n, 4}-!l2.
~rioccnoIo&Y 22, 225- 233. TAll'fTnlu. 0. , F. ANon. M. CHMal. K. W. SAanJANA. 1. L. U!
P1EII..5ON, R. A. and a J. GI!m1EJ. (1914 b): UhruonotI:raphy of the NET lIT L . l.ooulI (!Il83): Inltrtl de rk~ pour Ie con-
bovine 0I'Il)'. ThcrioFnoIogy 21, 49S-~. tr6le de la Rproduc1ion d'un gJWId troupeau de -xw
lai~ra. Revue
PIERsoN, R. A. and a J. GnmfElt (1986): Q.vian 1OI1icular popula- Mb;!. ~. 134. 4]9-424.
tioru; durina early JIfCIIWlCY in hcikn. 'J'hcriotcnoIOCY 26, 649-6!i9. TIiVEJ.Ne, M . A . M., a 5u.'ICl, J. SmAG and A . Pt_ (i98S) : Pres-
P1EU:lN, R. A. and a 1. GooHEa (t987) : \JttJuonogIaphi appea- nancy di.,nosb in COWl .... ith linear..my RII-timc uluuound 1QlI.
rance d the bovine Ulerus du~ the C$ll1)U5 C)C1e. J. Am. vet. mcd. nina: _ preliminary noIC. The Vctc.;nary Q.wterIy 1. 264- ID
AM. 190. 99!5- 1lO1. VDU.MEaHAUS, B. (t9!57): Untcr5UC:hungen Qber die nonnaJcn zykli·
QUlu; , S. M" G. J. HICXEY and 1. E. FoImJNE (1986) : G1'U¥o'th and IChcn \btndenlngen dcr UlCTIlItChlcimluout Ib Rindcs. mlbl . 'k!:.
rqrusioa of ~ follicles durina the follicular phase of the oeIUOUS Mcd. 4. 18-50.
eyele in heil'en undcrzoins lpOIIWICOUI and PQFz.r-irwl!l'''''! lutcolysb. WHITIl, R. A. S. and W. R. ALL£tf (198S) ; Usc of uluuourwl echosn-
1. Rep.od. ",11 . n , 211 - 219. phy for the differential dilgnosb d a ,nnulosa cell tumour in a mm:.
R£EvES, J. J., N. W. RAm,\/'l£l'l and M. HAUSEIt (1984): TransrecuJ Eq.Iine vet. 1. 17. 401--402.
n:aI-timc ultrasoond JCallIlina of the roN tq)fOductlve 1I"Jd. TIlerioge WHITIl. I. R .• A. J. F. RU5S E'. I. A. WlJOHT and T. K. WHYTI! (1983):
noIogy 21, 48!1 494. RuI.Qmc ultruonie K&Ilnina in the d~iI of presnanty and the csti .
S"USlIWY. G. W" N. L. VASDEM.U.K and J. R. I OOflF (19711); Grm- mation cl JCSlltionai • in cMtk. 'k!: . Rcc. 111. S-8.
lion . In: PhysloIocy of Reproduction and Al1irK'w Inseminalion d WIOIIMANN . 0. , C G. DoaN and D. C KaAEMU (1989): Sa deleClion
C1nle 2l1li cd., pp. 00-162. Eds. : G. W. Salisbury. N. L. \'anDrcmark dthc bovine feNS Wlin&]inear amy rul-timc ultruJno&nphy. Thcrio-
and J. R. lDdge. Vcr.., W. H. Freeman and Co. , San Franeisoo. senolosY 31. m .
ScHNEEllEU, J. (1984): UMeflUCilunFn nbcr das \Iortommcn YOn WII'l1U.lI . L. M •• W. W. Gl£EH and R. E. COM.nOCJ( (t942): PRnataI
InlCrOOl1l!IoItikcln bcim Rirwl . Schwciz. Arch . Tlcrhci]k. 126, ~Iop"cnl of the borooine. Univ. Minn. A,ric. E.l~r. Silo. , Teehn . Bul.
221 _ 229. 151. 1-44.

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186 Ultrasonography ii, s/,eep ami goats

"ig. 3.1: Schem:llic prcsentalion of Ihe transcutaneous ultra-


sound CXllminalion of a cwc. The probe is applied in the hai r-
less area ernnia! in front of the udder.

Fig. 3.2: Schcmlltic prcscnt31ion of Ihe tr.msrcctal ultmsQund


examination of a sheep. The probe is advanced about 15 em
il1lo the rectum umil the urinal)' bladder bcOOfllCS visible.

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Tec:hniqut of ultrosonogmphy 187

3 Ultrasonography in sheep and goats


Fo r many years various ultrasound u:chniques ha'"C until Day 35 o f pregnancy. Between Days 35 and 70
been used to dia~ pregnancy in shccp and goats. both methods appear to be equally accura!e.1lle tmns-
The A - mode and Doppler tcchniques used in the past cutaneous approach is preferred during tile second half
are considered non-imaging systems (U NOAHL 1969). of pregnallC)'. because it allows a larger ponion of tile
Neither techniquc is able to produce an image of the pregnant uterus to be visualized and it is much more
o::ona:ptlts. but mther illustrates its presence by detec- practical.
tion of a characteristic pattern of amplitudes or through Generally. scanners with sector. linear and convex
an aud ible or optically detectable frequency modula- probes at frequcnOes of 3.5 to 5.0 MHz can be used for
lion. Today, the imaging ultrasound te<:hniquc, the real both approaches. In practice the frequency of 5 MH.z is
lime B - mode ultl"a$OrlOgmphy, is used in small rumi- versatile. Linear probes appear beller suited for tile
nants (FoWl.El'l and WIUINS 1980. T"'llmJ~tER el al. transredal examinations, whereas sector probes are
1983 a and b). In oounlries wllere intensive sheep fann- p referred for transcutaneous examinations.
ing is practiced the $I:mographic c.amination of these
animal.<; for pregnallC)' detection and the detenninalion
offelal numbers is applied routinely (FOWLER and WIL- 3. 1.1 Transcutaneous sonography
KINS 1984. WHrrE el al. 1984. DAVEY 1986). 1lle im·
aging sonogrnphy is superior to the non-imaging For transcutaneous sooogrdphy the probe is applied
methods. because it is more lICCUmte and enables the to the groin area immediately CT"dnialto the udder (Flg.
operalor 10 detect Ihe number and viability of the fe- 3.1). In the majority ofshecp and goat breeds this area
tuses (BUCKREU. 1988. JAll.OON 1988). is relatively free ofwool or hair. allowing for good cou-
pling of the probe wilhout prior dipping of Ihe hair in
Ihe area. In addition. Ihe non·pregnant 3IId early preg-
3.1 Technique of ultrasooography in nant uteri are best visualized from this site. Only during
sheep and goats the last trimester does Ihe pregnant uterus extend so faf
forv.-ard thallhe probe has to be moved cranially in or-
llIe ultrasound c.amination of sheep and goalS can der to permit a complele examination of the fetltsCS. In
be performed in two different ways. 1lle internal geni· these C<lSCS some wool or hair needs to be reITllJl."Cd be-
talia can be depicted by applying the ultrasound probe fore the examination can be performed. In order 10 ac-
10 the veOlml abdomen· the transcutar>OOUS ultrasono- curately count the number of fet uses after Day 100 of
graphy - o r by inlroducing the probe into the rectum - p regnancy an area of 20 to 40 ern arournl the udder
the transrectal ullrasonography (Flg. 3.1 and 3.2). Bolh must be dipped 3IId both sides of the abdomen have to
melhods have been shown to be useful in sheep and be scanned. For a simple pregnancy diagnosis. in other
goalS (FOWL£II and WIUII,S 1985. KAsPAR 1988. words a mere distinction between pregnant and non-
KAspAII. 1989). 'The choice of which lechnique 10 use p regnant. the probe can be positionedjust cranial to the
depends on the diagnosis Ihat is to be made, Ihe type of udder and 00 dipping of hair or wool is required· even
lhe available ultrasound probe. as weU as the ..mking in late pregnancy (FOWLER and WtLKINS 1985).
conditions during the examination of large flocks. 1lle transcutaneous ult~phy can be per-
Based on CIIm:nt experience the trallSrectal examina- fanned "" hile the C\Io"t is standing. $illing o r lying down.
tion is more accurale than lhe transcutaneous method Practical experience has shown that the examination

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188 UllrrJsD/lOgraphy itl sheep alld goats

Fig. 3.J: TrJJl5CU lanl'Ous image oflhe urinary bladder (U) and fig. 3.4: T rnnsrcctaJ image uf lbe urinal)' bladder (U) and Ihe
the non· prcgnam uterus (arrows) of a C'\II~ in a sagittal section non-pregnant uterus (a~'S indiclte Ihe grc:lter culVa, urc)
with ve nlrodorsa lly directed beam. in a nanny goo, in a saginal section wilh dONlVCntrJl1y di·
rCClcd beam.

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Trtlllsreclal sofogroplly 189

should stan on the right hand side of the animal. In recumbency or in a hanging position (FOWLER and
most cases the full rumen pushes the pregnant uterus to WILKtNS 1985).
the right side where it is found with greater reliability In order to obtain the best possible image quality it is
and speed. The transcutaneous sonographic examina· necessary to apply a roupling gcl between the skin sur·
tion is greatly facilitated if a helper, standing on the left face and the ultrasound probe. When scanning standing
side of the sheep, bends over the animal and pulls up its animals the gel is applied onto the scanning surface of
right hind leg. the probe before the latter is placed against the skin.
The probe is applied 10 the hairless area in front of When the animal is scanned in the recumbent position
the udder, immediately cranial to the sebum filled in· the gel is distributed onto the skin surface. In prepara-
guinal gland. The sound waves are directed dOfS.1tty and tion for the scanning exercise it is very uscfulto starve the
slightly caudomediaUy. The probe is then pressed mod· animals by removing their feed for 12 hours during the
erately against the abdomen in the direction of the uri· preceding night. This precaution often helps to obtain a
nary bladder. When large flocks are examined working better image quality and thus leads to increased speed
ronditions should be optimized as far as possible. It has and accuracy during the examination (BUCKREtJ.. 1988).
proven most useful to chase the sheep on to a 80 to In order to ensure accurate results during the preg-
100 em high mmp where a standing examiner can scan nancy diagnosis a systematic approach is essential. First.
the sheep withoul too much discomfon. The number of the urinary bladder should be found and depicted. It is
shccp that can be scanned in a given period of time easily recognized by its anechoic lumen and typical
depends on the experience of the examiner, the pre- shape (Fig. 3.3). The non·pregnant ulerus appears in
dominant stage of pregnancy of the sheep in the flock the area of the apex of the bladder. The non·pregnant
and the prevailing working ronditions. Where the pur- ulerine horns are usually found cranially and ventrally.
!X>SC of the examination is merely to distinguish be- sometimes also laterally. to the urinary bladder. Also in
t,",'Cen pregnant and non-pregnant sheep up to 100 ewes the presence of a pregnancy. the uterus can be found in
can be scanned in one hour (DE BoiS and TAVERNE the vicinity of the apex of the bladder. Depending on
1984). If the number of fetuses in each pregnant e,",'C the stage of pregnancy one would then follow the ex-
must also be determined the e:<amination speed will be panded pregnant uterus in a cranial direction.
slD"'Cr and may take up to I to 2 min. per ewe in some
oases.
The above mentioned information on sonogmphic 3.1.2 Transrectal sonography
examinations of shccp relate to small to medium sized
flocks « 500 sheep). More intense experience on large A prerequisite for the tr..ansreClal sonogr..aphy is the
flocks in prominent sheep farming rountries has shown availability of II probe that can be introduced into the
that the diagnostic accuracy and the speed of the exam- rectum and whose scanning surface can be rotated ,·en·
ination can both be enhanced by the introduction of trally and laterally. Probes with oUler dimensions of 10
improved techniques. Such techniques include, for em length, 3 em height and 2 em width can be intro-
example, the usc of clamps that allow the C\\'C to be duced without any difficulty inlo the rectums of sheep
placed in a special position for the examination. In this and goalS (KAsPAR 1988).
regard it has been shown that fetal numbers can most Prior to a transrectal sonographic examinalion the
accumtely be determined when the c"..e is in dorsal animal must be properly TCStrained. This will help to

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190 U/Jraso/lagrapllY ill sheep and goafS

FIg. 3.5: Waterbath image of an excised OV'.uy of a L'We. The .;lg. 3.6: Photograph of the same ovary sectioned through the
'\\'0 corpor.! lutca s.how the moderate echogenicity of luteal scanning plane in Fig. 3.5 and showing the 2 corpora lutea. A
tissue. The ovarian parenchyma is mo re echoic. small cavity is present in the center of the left corpus luteum.

Fig. 3.7: Transrcctal imllge of a follicle (diamctcr - 7 mm) on fig. 3.8: Transrectal image of [y,'O large vcsiclc$ on the ovary
the o...ary of a nanny goat. The ovary lies ven tral to the non· of a e\l,e with suspected cystic follicular degcne rlllion. 1lie
pregnant uterus. Small UlTUYo"S demarcate the outline of the OV'dry lies cranioventrally of the urinary bladder (U) and yen·
ovary. large alTUYo"S that of Ihe utcrus. tr.1l1y of the non· pregnant u tc ru~ (alTUYo-s).

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OIurian stnlCfll1rS ill slleep 191

avoid injuries that may result from the animal's defen- inalion time of I to 2 minutes per animal should be ex-
sive struggling. Advancing and steering the probe inside pectcd (BUCKREU et a!. 1986). Provided the probe is
the rectum of a sheep or goat is achieved from the out- handlcd skillfully inside the rectum serious injuries do
side (Fig. 3,2), If the ultrasound probe is attached to a not occur. Irritation of thc rectal mucosa may Icad to
sufficiently stiff cable the laller can be used to advance mild hemorrhagc which is gencrally harmless.
the probe into the rectum and then to further manipu-
late it there. Where the cable of thc probe is flexible a
pipe: o r rod can be used to stiffcn thc connection to the 3.2 Ovarian structures in sheep
",abe (Fig. 4.3). and goats
The ultrasound probe is first lubricated and then
introduced through the anus inio the rectum. It is thcn 3.2.1 Follicles and corpora lutea
pushed cranially for about 15 011 where the urinary
bladder should become visiblc. Removal of the feces Based on thc findings of examinations on excised
from the rectum or the application of a coupling gcl be- ovaries in a watcrbath, follicles and corpora lutca of thc
fore the introduction of the probe into the rectum nrc small ruminants produce echo patterns similar to tho!ic
not necesSllry for the transrectal sonography in shecp obscl'\'Cd in C<lulc (see chaptcr 2.2). Corpora lutCil pro-
and goats. Once the bladder has becn identified. thc duce rcfloctions vety Iypical of thc low dcnsity of luteal
probe - with the sound beam directed ventrally - is ad- tissuc (Fig. 3.5 nnd 3.6). A cavity of a few millimetcrs
vanced slowly while it is also swiveled latcrally through can be seen at the centcrs of many corpor.t lutca. Fol-
45 degrees in both directions untilthc utcrus comes in- licles arc charnctcrizcd by the prcscl"lQ! of anechoic
to view (Fig. 3.4). Occasionally. fcces that lie bew,cen nuid in their antrum.
thc probe and the gut wall may obscure the imagc. By A routinc diagnostic visualization of the ovaries by
moving thc probe hack and fonh a lillie. o r by reintro- means of ultrasonogrnphy is not )'Ct possiblc at all stages
ducing it. this hindrance can be removed. When sheep of the cycle in shcep and goats (BuoaI.EU_ 1988). Fol·
in thcir second or third trimester of pregnancy are licles nnd corpom lutca of shcep and goats can be so
scanned it may be hclpful to clevate thcir abdominal smalllhllt they cannot reliably be detected by the U.'iC of
wal1 a little in ordcr to better visualize parts of the preg- currently employed ultmsonographic cquipment. In
nant uterus. Tnl.llsrectal sonographk examinalions takc sheep with unknown cyclic activity, for example, most
a littlc more time to perform than the trnnSCUlancous follicles ha\'C a diameter of only a few.millimeters which
ones. When many animals are to be checked an exam- is below the resolution capacity at which reliable inter-

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192 U/lrrlSollogmphy ill sheep (ifill goats

t1g. 3.9: OV'olI)' of a CYo'C afler supell)\'Ulalory trea tment. On Ag. 3.10: Ovary (cntnial lo the urinary bladder. U) in a f,.'\";C on
the left of the ovary !k..'VcraJ corpora lu tca (arrows) and on the the day of esu us afte r supell)\'Ulatol)' treatmen t. Eight to ten
right 3 follicles (diamelcrli bctwl,.'Cn 5 to 6 mm). (Ul trasono- follicles with diamelerliof 4 to 8 mm can be seen on the ovary.
gram from Nov . 22, 15:00. Thc sheep was treated as rol~: (Ultmsonogram from Nov. 23. 18:00. The sheep ..... as treated
Nov. 9. PGF2a; Nov. 19·22, FSH bid and Nov. 21. 18:00, as follows: Nov. 9: PGF2a; Nov. 19: ECG sid and Nov. 21.
PGF2a. Estrus occurred on Nov. 23). 18:00, PGF2a).

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Follicles 193

pretations of the image can still be made. At times fol- tmnsrectal sonography the oV'Jries were reliably de-
licles of 5 mm diameteror more can be identified on the tectable - if they had responded to the honnonalthem-
ovaries of proestrom e .....cs (Fig. 3.7). Large, anechoic py with follicular activity. The image resulting from
vesicles can also be found on the ovaries of animals suf- many adjacent. anechoic follicles was so typical that the
fering from the relati>.'Cly mfC condition of cystic de- ovaries could be identified without difficulty. The hlrg-
genemtion of follicles (Fig. 3.8). The cavities inside hol- est follicles of sheep had a diameter of 5 to 6 mm on the
low corpom lutea of sheep and goats CJn be confused d:ly of prostaglandin treatme nt and 6 to 8 mm on the
with small foil ides. The reason for this is that the echoic day of ovulation (Fig. 3.9 and 3. 10). Ultrasonography
wull of the hollow corjXlm lutea may be as thin as I to 2 made it possible to aSsess whether a ewe had responded
mm and thus freq ue ntly overlooked. with the development of mult iple follicles 10 the hormo-
B.1SCd on the as yet limited experiences it can be con- naltreatment. The exact number of follicles oould only
cluded that transrectal ultrasonography may be useful be estimated. Some of the sheep ,",,'CTC examined by
in assessing ovllrian features in spcciflC ovine and cap- tmnscutancous endoscopy after they had been exam-
rine cases, for example detennining follicular develop- ined by transrectal ultrasonography. This revealed that
ment after supcrovulatory treatment. Studies on goats the sonographic examination e nabled the investigator
have shown that the ovaries with their developing fol- to correctly establish the tendency in follicle numbers.
licles could only be identified in some animals during but that counling the exact number of follicles was im-
the first few days of supcrovulatory treatment (DaRN et possible.
al. 1989). Only prior to ovulation, when some of the fol- Occ-'.asionally. and only with difficulty, could ovaries
licles reached an inner diameter of up to 10 mm. could be identified that had not, or only inadequately. re-
the ovaries be found with ccrtainty. sponded to the supcrovulatory treatment by the devel-
In studies conducted by the author the follicular opment of multiple follides.
dcvclopmenl in superovulated sheep was observed. By

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194 U/frrJSOllogtTlpll)' i1l sheep o1ld goafS

Fig. 3. 11 : Sagittal section through the non-pregnant utcrus of Fig. 3. 12: Sagittal section through the u tcrus o f a ..·we o n the
a ewe. The greate r CUN'JlUre o f the ulerus is marked by day o f estrus follov.·ing supcrovul:nory treat ment. Mul tiple,
arrows. Tmnsrectal ultrasonogram. small nuid rollcctions (al"TOYo"5) arc visible inside the lumen o f
the ute rus. T r-.msrectal ultrasonogrJm.

I
I

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Uterine Stmctlll1!$ 195

3.3 Uterine structures in sheep During a transrcctal examination, a sagittal section


through the uterus is produced if the probe is held
and goats dorsally above the uterus, and iL'i scanning plane is
Generally. the findings on the non-pregnant uterus directed ventrally and parallel to the longitudinal ru:is of
as well as the uterus and conceptus during pregnancy the body (Fig. 3. 11 ). The cranial border of the uteru.'i, in
arc similar in sheep and goats (TAINIlJRIER el al. 1983 a the form of its larger curvature. can be seen as a com1:X
and b). structure. The lesser curvature of the non-pregnant
uterus can only be recognized with difficulty. On section
the uterine wall produces a homogenous. coarsely
3.3.1 Non-pregnant uterus granular echo. The uterine lumen or any fluid ilccumu-
lations inside the uterus can usually not be detected
The non-pregnant uterus of sheep and goats can be in the normal. non-pregnant uterus. Only during pro-
found inside the pelvis in the vicinity of the apex of the estrus and estrus of ewes treated for superovulation did
urinary bladder. It can be depicted by transrcctal. as the uterus regularly contain fluid accumulations (Fig.
....1:11 as transcutaneous sonography (Fig. 3.3 and 3.4). 3. 12).

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.lot.l. I 3: U"M"{I"'''''YplIl''''Do)'ll''{~.'Thc

~~~~~~:C~~=f:'u~~
(II'>iI.....,..OII'h<..,l"'~pcl>iclloor_Tl'lJ\<,rtXUIukn­
~".~

....J.l5 :1I..,""'d.~""Doy~<"prqnan'y~ .....


,·.;t"'"'''-'-'ion'tb",,,jVI<mb<)<:>n''',~ .... nt..'''''nju>t
.....,WI)IOth<urioIDyblacidct(U).'Tkirl.. nwe""'dwn-
... ""........,.ro.n12101~mm.T.. rNe<.'lalu~

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Pregllullf //tents 197

3.3.2 Pregnant uterus Prior to Day 20 lrnnsrcClal sooography may be lL<;C -


rul as a research tool to slUcIy. for example. embryo nic
3.3.2.1 Before Day 20 of pregnancy death : it docs not ronstilUle a practical means of relia-
bly ditlgnosing pregnancy III this stage.
The carlicst indication of the presence of a pregnan-
cy is thc dcmonslrl.llion of embryonic flu id inside the 3.3.2.2 Day 20 to 40 of pregnancy
uterus. The trophoblast of the ewe and goat begins to
elongate ronsiderably from the Day II of pregnancy From Day 20 to 25 of pregnancy the dcmonstmtion
(KING et al. 1982). By Day 13 to 14 thc embryonic ' 'CS- of embr)'Onic fl uid is regularly possible in sheep and
icle lies as a 10 em long tube in the utcrine hom ipsilat- goats examined by transrcctal sonogrnphy (BUCKKEU.
eral to the corpus luteum of pregnancy. By Day 16 to 18 1988). At this stagc of pregnancy anechoic embr)'Onic
it extends into the contralateral hom ( R O\\'SON and fluid accumulntions occur inside the lumen of the early
MOOR 1966). Around Day 20 of pregnancy the narrow pregnant uterus - frequently C'o'cn in scvcml places
embryonic vesicle extcnds from the tip of the pregnant which appear as a series of vesicles (Fig. 3.14). "1lley C"".t n
hom 10 the tip of the contralateral hom of the uterus. usually be found immediately cranial or cmniovenlrully
TransreClal sonogruphy OCC'dSionally allows the visu- 10 the urinary bllldder ( Il UCKRElJ... el al. 1986. GEAR'
alization of anechoic sections Ihrough the emb.yonic HART et al. 1988). The amount of embr)'Onic fl uid in-
vesicle between Days 14 and 19 of pregnancy (BUCK- creases rather mpidly over the following few days so
REU.. 1988). During this period the demonstration of an thai ever larger portions of the embryonic vcsiclc be-
anechoic lumen is, howC\'C r. unreliable and cannoc be rome visible. The largest cross sections through the ,.cs-
used to positively diagnose pregnancy. The chorionic icle increase from around 10 mm on Day 20. to 15 mm
and amniotic vesicles rontain so little fluid at this stage on Day 25 and to 20 mm on Day 30 (Fig. 3.14to 3.16).
that the embryonic vesicle of only a few millimeten can It is often not possible to s(''C the ronncctions be-
only sporadically be visualized (Fig. 3.1 3). Small fl uid tv,cen Iocules of embr)'Onic fluid which .....,ould demon-
accumulations in the uterus can also originate from stratc that they are aU parts of a single embr)'Onic ves-
causes other than pregnancy. icle. More oft en. an inlllgc consisting of apparently

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198 UllfWOllogrophy in sheet) alld goalS

Fig. 3. 16: Utcrus of 1I1.~'C on Day 29 of prcgn:mcy. Three an· Fig..1 17: Photograph after a sagittal section through the right
echoic sections through embryonic vesicles are visible. Trans- uterine hom of a C\Io'C on Day 29 of pregnancy. The uterine lu-
rectal ultrasonogram. men is partitioned into Sl.'Vtrnl compartments by vertical folds
of thc uterine wall. 8oIo.·lshapcd carunclcs (small arrows) are
recognizable. The greater curvature is marked by large ar-
rows. the cervix (C; partly CUI 01T) lies on the left.

fo1g. 3.1 8: Uterus of II nanny goot on Day 24 of pregnancy. The fole. 3. 19: Uterus of a nanny goat on Day 25. The uterus lies
echoic embl)"O (E) lies. surrounded by anechoic embryonic cranial to the urinary bladder (U). In the ven tral sect jon of the
fluid. in the vcntr:ll section of the uterine hom. Tran~al ul- uterine hom 2 placenlomes can be seen a~ bullon like protru-
trasonogmro. !>ions. Transrcctal ultrasonogram.

AvlO sko zasc 10 radivo


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lantochorionicYC5idelbt-rcbyprodudngtllemul!i!ocu,
wdlea,
Thecn'h'Y"'fi~hccomevisihkber..wnDays25
and 3O of prcgnarot)",uccasionallycarlicr(F>g. 3.1S). If
the..-m/lryo!lareclcarly>-NbictheirheanbeatOU1be
_nat\hl:~""'timt;(KasparI988).Att"",.uget"'"
cmhryo!l ...iI!Slililievt:ry~tothcutcrilltwall
CaremouJdbctakcntod;ffe"'ntiatcbe~"IIplac­
cntOllll."S .ndtbe embr)ol{iJlJckK>J.l. ctai.l98ti). 'llw,:
pia<:entO!l1<-"Srorsl!)ewmcappllrcntonlheu tcri"" ....ull
fromahoutDaylS. Atthislol.theyappcarasbotioo
shapetlprOl"""-. . r~~el5widc(Ftg.3, 19)
·n.eya",.oo.."""r.dcarly~IIo.'T(h.anthccmhryt.-.

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r-""J.lt:\I•• ""of • .....,""Day29"fpn:"'"nc~i,'lbeam- t"J.11 ,r""""""'"""",uk~of.hcu.<""d.


_(A) .... mlUnd<lheembr)oo ... lh'" h)'J'C~1ine ""ool>ay35ofl""lI"""')'.Too".ml>lyoJ(L)1U>Il4 ....
I"nIAIII.....w ...........-.gnm. """momsofU~uI"""'<ZIbc~.

~. . U:'T"'n'm . ..."OfIu.y40"'I'''."'''''nt)'.(""m<o.'''''''" ' ..... :uJ,llorihlnllll""""'''''h''''''''.n"...... fC1 .... ''''


lions .hl"llllJl>'W<l k'I1";:«F) .... .-..illIe. r"""",,-~ .. u1tr""-... ~ 4Oofprt£llllnt)'. Tho. """""'-f'WTlp-Icnll"h mo ......... 4 an.
rq",m h<:aJ (H) "",I crooo """""''' U""""".he 1,,,,,«1""'-
(~""""')""nbcrc<XJSl'''ed.Tratl:'lr«talul.r..,.''''~"m

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3.3.2.3 Dtly40 to IOOofprcgnanC)'


From Day 40 Qfpn:gna1l()'counUngof the fCIU=
bca.>mr$ incrcasin&IY more fca...l * (l'ig. 3.22). 11.:
cdlOic felu.w. an: $Urmundc<J by larte am(JOlnl~ of
hypocdlOicnuidbo.:t"'ttnDay>~andlW.tho,.')Iare
alv>",,"Uk"P3raledfrumoneanothcrlUldcanthusbc
distingui.<hed with Cfl'.(. During this period thc fet ......
rapidly ~la~cr.Thci r~"""'n .runlJrlcnglh is
ahoul 4cmU'OUnd Oay40, ~a.mg IQ .boot 7anby
[)"Y~{F1g.2.23).Alabou\O'y60lhc~·ruffiJ>-
le ngthofovi""andcaprioefcl u."", ... rpa~a lcl1gthof
10 <:m {EvA.'15 and SJ.cx.\\l7J) ...ilich .. the \imiluf
5 MHI pmbcs W.. 3,24). For lhc oompkte im:tgingof
fC1U."", the ~pplic~lion of lower fre'lU~ncy ultrllSO\lIld
holds advIIntagcs fmm this time onwartb.

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202 UllrtlSOllogrtlpl,)' ill sheep alld COO's

tlg. 3.l4: Trnnsrectal horizontal section through 3n ()\line fe- FIg. 3.25: Transcutaneous horizontal section through the skull
tUSOfl D3y60of pregna ncy. In Ihe apex of the IhotaX (arT\)\o\'S) of an ovinc fe lus on Day 65 of pregnancy. One eye (af'l'O'W )
lies the hean. to the left of tha t the modcrnlelycchoic liver (l ) with its le ns lies at the top. the othe r eye (arrow) at the bot-
with ~ sections Ih rough some large hepatic blood vcsscls. tom. To the right of the !auer lies the h)'pcrcchoic O'.~J.I of the
cranial «wily. TlK: bip.lrictlll diameter (nPD) mea.~rc:s 23.5
mm.

FIg. 3.26: Trnnsrectal horizonlal section through the abdomen fig. 3.27: Trnnsrectal horizontal section through the thorax of
of an ovine fetus on Day 96 of pregnuncy. The h)'JXlCChoic lu- an mine fetus on Day 96 of pregnancy. Shadow anifactsorigi-
me n of the rumen (R) lies at the top. the liver (l) at the bot- nale from 11K: conically ummged rib cross seclions and run in-
tom, an l'Choic \'Cnebru on the righ t. to the tJcpth of the image.

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Pregnant /Items 203

During the second and third trimesters of pregnancy By taking fetal measurements the age of a pregnan-
nume rous organs of ovine and caprine fetuses can be cy can be estimated or, in the case of a known service
depicted sonographically (DE. BoiS and TAVERNE. date, the developmental status of the conceptuses can
1984). In general, the different organs and body parts be assessed. Next to many other body parts, the bipari-
prod uce images similar to those described for bovine fe- etal diameter (BPD) of ovine and caprine fetuses is
tuses (Chapter 2.4). The cranial cavity and eyes, heart, particularly ,,"'C II suited for fetometric evu.luation (Fig.
stomach, kidneys and umbilical cord can be depicted 3.25). The biparietal diameter of ovinc and caprine fe-
with particular clarity (Fig. 3.24 to 3.30). As a result of tuses increases nearly linearly during the course of preg-
their intense cchogenicity the bony parts, such as the nancy (HAIBEL and PERKtNS 1989, HAma el a1. 1989).
skull, spinal column, ribs and the extremities, can be On average, the biparietal diameter grows fro m 7.5 to
identified without difficulty. The fe tuses show intensive 10 mm on Day 40, to 23 10 26 mm around Day 70 and
mobility at this stage, resulting in freq uent positional to 40 to 45 mm al about Day 100.
changes (SoIEERBOOM and TAVERNE 1985).

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I'regnammmlS 2115

During lhe ""cond half of pregllancy the placen· naoc)'. As pregnancy progrc&SCS. how!."I~r. lhe corooom
\OmI..'S.apant'romthefe!u... dominaICtOCsonogmphi<' ical hetlCfil derived from applyingdifferentlal feeding
image(Fig,3,2Iltn3.31).Thi;isduewtheirlargenum- regimes for c"'e, ~ourying si~glelon or multiple fctuses
~rs.theirincrc;,scd"izcandthc .. d~ddi'tanceslx:. Jiminil;hc". WhereearlypregnaOC)'diagnoscsbetwttn
tm:cnindj..idualpiacentomcs. TIlcyareoflcnthcfmt Da}~ 20 and 40 arc 1o be made. the mm.-rectal
posili.-e,ignnfpregna",:ythalbccome,evidentduring approach should be chosen (Blioaun el aL 1986). AI
an ultrasound =tminatKJn. The demonstration of 'ncir Ih;"timetheindividualexaminalionblIlOTCtimcoon·
pn:scm:ccanbeuseda,a"'liahle"ignofpregnall<.)'~nd .... mingand lhe diagoc,,;is lc" ",-,-'Urmc panly due 10 the
i; sofflCiemmmakca di"Snc.;isuf"prcgnam". possibililyofembryonic~.
In~heepandb'OOtslhcplacemome.prod~avcl)'
cru.ra<:lcri,tic""""&,,,phicimagc.lniliallylhcyare nat 3.3.2.4 Day 100 to 150 of pregnancy
andbun"""'apcd.bulaspn:gnam)'progr .."""'theybe.
rome more ~'Up-,haped (Fig, 3.29 and 3.30). The pc. Due tu it, heiter image quality, ullrao;oo.m(1 al 5 MHz
riphcral edge of the carunde lrulge.; up wilh thc ron- b best .... iled for p"'gnancy diagoco;cs u~till)ay JUIlof
Cl'.ilj-'direcroot"",·aJ'(i<;thcfel",,))cpcndingonthe pregnancy. TlJercaflcr, lhc use of 3.5 MHz ullrasono-
IllgleoflhcSCCIioo.I""'l}picaJ imasesofplaccntomcs gmplty may Ix pr.,[erred, because it offers a larger
.reg"ncml"dbylheultra'iOllnd(Fig.3.31),s..~illal,,",,_
S<<lnning field wnich facilitatcs lhc.-isualizationofthc
IionslhrOllghplaccn(orncsMUltin'lickle,hape', largeroo",-,,-,pluscs. Al this stage the SC3~ningofcrani
...-he",a, horiwmal SC<.1ions produce ring "'aped im · all)'dispiaecdpart,ofthefelU'I,a'wcllasO)Unlingklal
ilgt!'i.The lalterh."" an echoicperiphcral mnc and a numoo", "'" o~ly po<sible if thc animal, an: cxamin,..<.l
bypocchoicrenter.ShccpuwallyhavcbetWl.>cnWand transcutaneousiy. Even .... ilh t""""'Uta~""us ""nogm-
I OOandgoalsbelwccDltiOandlHOplacentom",,(R I ~RA phyilmayoodiffll'Ulltoreliablyestahli'hthcoumhcrof
19S4).1bcdiffcre"""innumlx:r<;O;SOIlClgruphicallynot fetu"",afierDaylWofpregnancy.Thcfctus<,',arcnow
ob-.-ious. so large and lie"-OcloS<.'locach other thaI ithero=s
Manag<'l'l'of)arb""hccpflurtsoftena,ktileques- rathcrdirr...'UitloJ;stinguishhetweenthem
Iion:WhcnisthetimeatwhichsoOOSraphOcpregnancy Ouringthe last trimeslerofprcgna!tcyonlythccau·
examinations yield thc higltCSl possibleaccumcywhi!e dal ponion.of Ihc pregnant utcrusca~he examinedb)-'
at the same timcproviding the """'""",oomicallyrcle. tmns!CClal "-""Waphy. DemolLslration of placcnlomc~
.... nl informalion'l Transrulaneou, examinations wilh ;s possible in all ca",-,so Ihat lhe prcscro:coh prcgnan·
~)'can he dia8"","""eve~ allh;"f>fab'C. Fctal body paru;
.... apprupriate 'lCannerca~ Ix:pcrfofTI\(;d al high speed
., large floc .. a~d still )'icld reliable pregnancy diag are,h<'N.-ever.r!Cqucnllyimpossibletodepictbylrans-
"""'-'S[rom lJay35 to4Uofp"'gllancy.TlJeoptimaJ rectal sonogmphy. The latter prohlem ca~ oflcnlx:
time for an acrumte prcgll~'tcy diagnos;" and .unul "'l\-ed by elevating lhe ahdominal .... ali. but the depic·
tio~oflhcfctuscsintotooroountin8theirnllmhel'l're­
Ianeou'lly O)U,,( ing the numlxr"fft:tuses i, hetween
Da)"l453TldS5(BlJCKRElll<)I*l),AcruralepreSJlaOC)' mainimpoo.sible.
diagnoses caII still he made i~ lhe lalerf>fagc:. ufprcg·

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206 U1lmsollogrophy it! sheep ami goalS

Fig. 3.31: TrnnsreClal ultrnsonogrnm of Ihree placenlOmes of


a nasmy gool on D'JY 63 of pregnancy. Depending on the
dircclion of the SCdional plane the cup-shape of the p~n ­
lomes l'.iJl produce a vaneI}' of images.

Av s 0 Z"l~
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3.3.2.5 Accuracy of sonogrdphic pregnancy Ikl\>-ccn [);I)'lI 40 and SO of pn.-gnaO<."}' Lhe aa:u1'llC)'
diagnosis nfthc:pn!'ittvetnsn"""YdiagnoM!;(prediaiYev-..luellf
po!il~diagnoMs)aftcrLraft!,C"ULanC(ltI!;~ic
ThcultrdliOOndteclmiqucsprcviouslyw:o.ItQo.Ii.otg· examinationslit:slUO<lnd<J5%.Af!crVay5(lLherc·
_pn:snancyinshccpandgoat~'lI1eA - nlOd<:and liahilityin<:rca<;C510ovcr9'l%{fuVt"'1-MandWII-xn......
D<wlcrt~'ChniqUl.-,)· <mlyyicklco.lsatisfacMy results l<J!I4. Tr.v(RNl!cI al. 1'J!l5.GE"ARlLARTtlul. 19S8.JAIl-
from Day60ofpn:gnancr(I~N""HI . 1%9. 0IT(la1 'ION 19A8).
1981. Ho:sCllct ill. 1981. WAITet.l. 1984). Both Oncrca-;orlM"",aUmunbcrufl""l"1"lJllo<l\Jdiaj.;lLOiCS

~~~t::n(~::~=;~;:
cannntbep~ntedi!;th.atananimaifoundP""lJl3lllin
vcrycarly pregnancycan:IUlJcrcmbryonit: Ior!f;and later
~ry~rienccdope«llO/"Sll1elKCUracyindifk""nlial be counted II!< a !aLoe pooitr..: diagn05is. Additional

~I\>~~na~~\~~;rr:~:~~
faI'JICp08itivcdiagnoscsmaybcmado: ...·henpalho1ogical
lluidaccumulatiomintbeuterm,!-UdILrl<lC'."Urinp)\>'
91\3, I .... NGiOKIJctal. 191>4). Undc:rfteldrondition., 01<:11"3, hydrometra and hydrallamrm (\C .• are wrongly
powl"VCr. it Ita:; bo.,.,n"oo...l1 thaI the IlOCum"), of the im"rpr"ICd U~:.ignl ofprqpIUOK.-Y. £vcn n"id ll(X:umula-
~~",-ruoofl(nOl\IChwor.e(SCH[lIIll etal.l~ll6. tiom in tbe gul or in tbe atxlonten can lead 10 fuke

~~~~~!rte~~t : t y : I : ! ; U !
~livc di;,~~. Equally. ""huic (any I~ may
f:mclybeidentifoedMft:tal<lruc1.ures..

~1=':~llfimaging!l\lOOgf"~phytho:lKCUr...."}'
llJo.,5I;nsiti-.i lyofthcmcthodin<.>.lmXltyn:cognizing
allprqruonlanimakandtberteptiYep«dict;"'VlIluc

~P1~~~~~~.rel~~I;'~:=:'S~~~
arc.\OrTlCl'll\at Iowcr (80-90 % ), bcca,* ~ happ:n.
oa:asionallythat P"'gnant "mn",lollire idcntif...-..t ;is
98.~. O"VIV 198Ii).ln manyca..:s tile application of l1Ol1·prcgnanl(fi',"-':K ..JJ etaI.1986).
islcch1\iqlK:hasalsom3dclhcTdi~h~dirrcrcnl i alion Diffcrc!11iUlingbylran,,::ularn."1JUSiiOIlOgraphybc-
~en5i~glelonandmultiple.pregnut>cil.,ptl'I"iblc. tVt-ecn singleton and mulliple pn:snancie; i5 ,..,tiably

~~:i:;~~;~~':~~:;;~ll:r~~~
poMiblcbo;lwccnl)ays45andlOOaOOllCCUI'lIC)'can
,..,adt 90 to 9S % {DI!BotsaodT"VONll 19114, WlIITE
~~ I-001.1~ ctal.l987) cl al. I984 . I'owlHlandWll.Kl!'CSI984 . 1'ov;' -"Kand
lbcopi.-ruKiI)'<.>flh.etnCtbudinT\.~non­ WIUUNS 1'lSS, T"\"ElI..'<Ectai. I~, DJI\"I!Y 1986.
gnatot animals is wry high if the operator is;ode l..or.t1E el al. 19S7). EITOI""S OOCUr ",ilh mtJ1' ....ing
~lcty""-PCricnccd(GlWUtA.RfClal . \988).lf~ frcqucncybcforc Day 45 and aflcr Day 100. 11 is\-.:ry

rn;:::~":: aa~r ::.~) :r~:-~rl~~=~~


easy to make a mistake in dc:tennining whether an
animal;' CIt")";ng twins. lripk:ls or ~vcn q,,~drupkts
galiv(n:sult~ontyocrurifthcutcru~hnot~tivcly (O\1,VlSandAR~ONGl9!!5).
nlifted during thc cxaminalion. This pmblem occu'" Tltercf~ lTaMm:la1 ~"'f>hy .. not well .ruled
~. (rcqucntlyinlargcandWCUrcdWlimab{IV.st>AIl fur OJUntingthe numbcrofktuscs.Sali>bctoTyrcsuh.~

f9M~ lhe tno'l';n,ctai tcdmiquc the acruracy of the


0Ul usually only be attained from the 5th totbe 7th
-..-ccU of prcgnancy. ·lbcrcaficr. doc 10 tbe cranio\-en-

~:::~:;t~;;;=IUO~ ~trtya-[)ay traldi<placcmentoftMute"",elTOl""Sllcrurmorefre..


qucntl)· {GMII.IWtTcta1.I988. K,o.~III1.I988).

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Uterine patholQfff 209

3.3.3 Uterine pathology placcntomcs are present. Treatment with PGF2a usu-
ally leads to the prompt emptying of the uterus, but
Pathological conditions of the Ulerus, such as py0- small amounts of sonognlphicalty de\l.'CIable fluid may
metra, hydromctra and mucometra. and in case.. of remain for some time (Fig, 3.34).
abnormal pregnancies, such as embryonic deaths, fetal Early C3.'iCS of hydrometra , where the amount of
mummification. hydmllantois and hydramnion can all fluid is nlIher small. can be confused with pregnancy
be diagnosed by ultrasonography (BUCKRELL 1988. during sonographic examinations. In doubtful cases the
GEARIIART et at. 1988). doc should be reexamined at least 40 days aftcr the last
Pyometra in the cwe is chamcterizcd by an intra- service date. At this time a fetus should be dctectablc in
uterine fluid accumulation which contains obvious re- a pregnant doc and an accurate diagnosis can be estab-
flections (Fig. 3.32). The echogcnicity of the fluid de- lished (PnTIcRSE and TAVERNE 1986).
pends on the rdllive llmount of cellular nmterial in thc Dropsy of the fetal membranes includes those condi·
secretion. A snow-storm-like image is typical. tions in which there is a pathologiC'..I1 increase in the
lbe tenn hydrometra in goalS signifies the accumu- amount of feta l fluids. as in hydrallantois and hydmm-
lation of large :lmounts of sterile flu id inside the uterus nion. In a C'.tSC of hydrallantois the sonogmphic exami-
in the presence of a persistent corpus [uteum and the mllion will rcvcal a uterus that is filled to the extreme
failure of the doc to cycle (PIEll!RSE and T,WERNE with anechoic fluid (Fig. 3.35). A~ is the case in hydro-
1986). The ultrasound image in a case of hydrometr.t is metra. hypcrechoic sections of thc thin utc rine wall will
characterized by the large, hypoechoic fluid ,1C:rumulll- travcrse thc allantoic fluid. In order to diITercnti:lte be-
tions insidc the utcrus (Fig. 3.33). Frequently, seveml tween hydrallantois and hydmmnion on one h:lnd and
closely adjllccnt fluid filled cavities scpanncd by sec- disturbances in non-pregnant animals (pyo- :lnd hydro-
tions of thin ute rine wall can be seen. This image origi- metra) on the other onc should look for few l structures.
nates from the coiling and kinking of the uterine horns Typically. in cases of dropsy of the fctlll membmncs.
which are filled with secretions and portions of which placentomes and/or fetuses can be depictcd whereas
fonn tightly lIppositioned loculcs. No fetlll echoes or these :lrc not prescnt in cas(''S of pyo- and hydrometro.l.

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210 References

References to chapter 3 J. N. B. SH U~Il"". P. S. FISD: . L . AIJoI~. 0.


u.."'<lfOlD . O . A ••
P. HEAHEY ud O. I. MAlCUS (t984) : impi ooeci diagnostic 1ttII/'IC)'
by rqJelilivc uilluonic: p.qnanc:y testi.. in sheep. Theriosmolol:Y ZI,
Bucu.w.., B. C (t9S8): Applications d ult~ in ,eptodllC- 691-
tion in IhcqI am.! p t I. Thc:rlcsell!llocY 29, 71-84. UJoIMHL, I. L. (1969): ComparUon ofuilruonic IiedIniquea: for the
Bucu£u., B. C , B. N. 8or<.. lTTand W. H . JOONJON (!986): The use d' I: ' Iion of preJIWIC)' In C"o1lt1 J. Repn:d . Fer! . \8, 117-120.
d lUI·time uJlm.oond =WI, b urly prqnam:y d~ in V p Um:too.HL, I. L. (1971) : Prqnancy d.iaJnoW in the ewe by in!raR!CUI
n .. l ioJF",....1oQ 2$, 66' 673. Duy;Acr. J. Anim. Sci. 3Z. 922-9U
D..wu. C G. (1986): An C\'ahwion d prqnIIK)' _illl in shttp LooUII, D. N.. 1. T. HAu , S. McRoiem and A. WATUItOUSII (19!1) :
Ulilll • 1U1-ti_ ultl1llOUJld ~r. Autl . vet. J. 63, 347- J.4.!. RuI-time ullfUOnic: ~ in Wep: The ~IIS of the lirst )UI"
DEAl, D. W. (1977): P'rcJnant'y diqnosis in the ewe by ." uJtr1l1O" ic: of its appIicalion 011 farms in IOUth ... d Srolli nd . \Itt. R.tc. 121.
~ poobe. ~. Roe.. 101, Ill-US. I46- W9.
Of: Bocs, C. H . W. en M . A . M . TAVW'lfI (I~) : Dnl:hliJb:idoondc:f- Orr , R. s., W. F. BlAiJN. T. F. I..oCJc , M. A. MEMOIfaDd J. L.$'n::MIA-
md; bij lid Khup D. M. V. ~melllioOl:le echclsBfoe. Vlums TEll; (1981): A ~ of intmt:aai Doppler aDd =1aI abdominaJ
d>e1ccr E' Ik. TIjdscht. '3.
240-252. ~palion for ~ lCSIilll in pili. J. Am. ¥n . mc:d . All. I7&.
00. ... C. G., B. A. WOLI'!I. E. BIiSSOIJDO and D. C. KAAEMEII (1989): 7JO-73 i.
FoIliculu delection in goau by ulti'ltliqraphy. 1'herioJenoI0cy 31, o.."F.IQ, J. L. and 1. R. ~NO (198'): [)iq:nosis d IbeuJ number
"'.
EYoVIs, H. E. and W. 0. SIO. (W1J) : PrmalallkYclopiiltl'll of dune-
in prolifIC 1Ihcc:p. Proc. N. Z. Soc. Anim. Prod . 4'. US-U7.
Ptero.se, M. C. aDd M. A. M. TAVDN! (1986): H)'drometrl in JOIIS:
Itic and IabonoIDf)' 1I\IIIUl1ab: Growth CIIrYeI, a1ml&l b lUm! and ~is witb real-time ullruoulld aDd lrtatmenl witb proscaatandins
5Cko:d .dbeuoe::., Zembl . \lei. Me<!. Reihe C 2. 11 ...... 5- lIT Olt)1Ocin. Theriogenology 26. 81l-821.
Fowt..u, D. G. and 1. F. W(U(JNS (1980): The identi(1Wion d linalc RrEaA , G. S. (1984): Somc: limilariticll aDd clitkrenc:a in female aDd
and multiple bcarin& _ by ullrQOnic irrlaJina. Proc.. Aust. Soc. p i reproducIion . Proc. ll" 1111. Conar. Anim . ~pn:d. &. A . I. IV,
Anim . Prod . IJ, 492 . VIl- i - VIl-4.
Fowt.Ea, D. G. and 1. P. WILKINS ( t98oi) : 0iqn0I.is d ~ and RowsoN. L. E. A. and R. M. Mooa (\966) : DeYClopiikUI dthe Wep
nwnbcr ol roctulel in abcqI by rcaI·time ulllUOClk imqil1a. I. Eff«u oonotplWl .... ri.. the fi.- bil'lflen d.ys. J. AMI. 100, m _ 78S.
d number oll'ocnaKl. stIiC d gWMion. opc:nwr and ." I: , d _ ROSCH, P., M. BDIcInow lind L. Eoor.a (1981) : Du EdIoIoIverc.b-
on xtUl'k')' of d~ Uvestock Production Science II , 437--450. mI mm Tric:11\i,kt~ beim SdJaf Un ~h tur Ulln.·
Fowwt, D. O. and J. F. Wlwm (1985) : DeYeIopina. rlCld IOCbnique JdWI· DoppIcr·Tc:dmik. TimmI. Umsd! . 36. 180-18&.
for ~rmini", liner ralmbcr durina prqnancy in 1Ihcc:p. Miscc:llancoo.lI ScHnuooM, J. E. M. aDd M. A. M. TAVU1fl! (19"): A Uudy of the:
Bulktin 10. Ikp. of A&ric'u11U~ New South w.1c:s. pregn&IIl liIerUI of the ewe and the: plllli.. real-time IlIIlUOUnd 1I:aII'
oe.uH~. M. A. , W. E. WII'IGFlI!I.D . A. P. I(Jo,'l(lHT. J. A. SMmt, 0. nina: aDd c~. 'kI. Rca. Com . 9. 4S-j6,
A. OUCIAtt. l. A. BooH aDd C. A. SroKf.s (1988): R".I-lime ufuuo. ScHEPlE, K. M., O. EMEWtO lind L. MAAsHAu.. (1986): VaJIcic:bende
qraphy for ~nnini.. pIqllUIt)' IWuI and viabk kill numbm in UnlCl1UChuna: lIIr TficlKi&Ice,lMIi,,1IOK beim Schlr. Mh . ~I . Mee!.
cwc:a. Ther;""""""", Xl. 323-337. 41 , 158-160&.
HAJau, O. K. aDd N. R. P£Jtxoo (1989): RuI· time uluuonjc, biparic.- TAll'I1lIlIflt, D.. L. 1..tJolJa. M. CHAAlIl. K. W. SAlIWAI'IA et B. DeNIs
1&1 diamclCr of talNid lrimes~ Suffolk ud FiM ~ Ii:'fIIses aDd (1983 a): ~ de ]a rwm dIa ]a brebil pal" 6c:1JcJIomopphie.
prediction of Je$tlUonaI . . TMriq; idIocY 32, 86J 869. Rrvue MM . ~ . 134. ,23-,26.
HAIBEL. O. K., N. R. PEulss and O. M. lml. (1989): Breed differen· TAlImIalflt , D.• L. 1IIOIIl, M. CHMlI, K. W. S~.pt\1'IA et J. L. U!
tU in biparinaJ diamd... s ofsccOid trimester 1bgenburg. Nubian aDd NIIT (l9!3b): OiaeooIIic de ]a i' a im dIa Ia chhre pal" 6cl......,.,.
AnJOn. 10111 rctu.ea. TM~ 32. m-8J4. ,rapIUe. Rrvue M6i. vtt . 134. m -m .
IAlOON, C. (1988): Utiliu, ion Kt\IeIE .... d~
4!~, dIa Ia brdIis. R.tcl. Mid. v4!t. t.c. Aim 164, I35-MO.
de,. It'itN\, en TAVfltNE, M. A. M .. M. C. LA'oOtN , R. V/lN Oil«D aDd O. C. \c\N oae
WR'o'OEN (19~) : Accuncy of pqnano;:y ~ and prediction d
JV,s ..... , B. (1988): Bc:iuq: tIIr Sonograp/lie in del" Cnlk""'livben foetal numbers in Wep with linear·amy reaI--lime Ulll7HNnd JCaMinc-
Diapostik, ~re mr p, ' grIN" del" Orwvidilit bei SdJaf und The \bcriewy Quanc:ly 1, lS6-Z61
~. ncunpberichl . KrankJx:ilen del" kkincn W"ledertluer. der b"uop, M. J. and A . L. $l..YTElI (198J) : Pqnanc:y di. . . .is in the:
DYQ, Oit&n n.6.1988. CWC'. 1. Anim. Sci. 57. 1-'.
K.url\l. B.. (1989): UluuchlUwtlSllChu"l bei Ziqcn: Eine m __ lb- WATT. B.. R., O. A. AADEUOII aDd I. P. CANI'8EU. (1984); A CIN,,,*"'
Nee Methode :cur TrkhliPc ius nnelhlJ\&. lkt" Ziep:>wlchlCr ,. I0Il ofm mcthocb; UKd for deliXl'na: prea:nancy in Jhco:p. AIm . ¥n .
I-U. J. 61, )77- 38:2.
Klloa . O. 1., B. A. ATlUIOOf< and H. A. R~ (1982) : ImpIanIa· Wllrte, I. R., A. 1. F. RIIS.5£I. and 0. O. I'oWull (1984): RuI--lime
lion and early pIai;e,ulion in donw::stic: u"",I*,. 1. Repioe!. Fa1., ultn_ic: seannina: in the d~ ofprqnancy and the: ~rmi"'l ion
StIpp!. 31, 17-30. of fttIl numbers in sheep. 'kI. R.tc. IB. WO- W1

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212 U11rosollogrophy inpigs

FIg. 4.1: Transcutaneous ultrasound examination ir, a pig. TIle r ig. 4.2: Transrectal ultrasound examination in a pig. The
probe is applied just above the last three mammal)' glands. probe is dired cd from the outside by a guide rod (see
Fig. 43). introduced into the rectum and mtllled back and
forth O\'er the uterus and the ovaries.

fig. 4.3: For transrectal ul trasound examinations in pig1 the


linear probe and itscablc can be stiffened by a metal o r pla~ic
rod.

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Technique of u/lrasonography 213

4 Ultrasonography in pigs
In pigs pregnancy diagnosis by ultrasound tech- ed initially, the same procedure is repeated after mov-
niques have been utilized for many yeaffi. As in sheep ing the probe several centimeters in a cranial o r caudal
and goalS the non-imaging techniques, such as the ultra- direction. In order to depict the lert and right compo-
sound-Doppler (FRAsER et al. t 97 1,ISAKOv 1974) and nents of the uterus and ovaries of pigs both sides of the
A -mode techniques (UNDAHL et al. 1975, O'REIUY abdomen must be scanned. In doing this it is often pos-
1976, PEJSAK and WIERZCIiOS 1981, BAL.KE and EL- sible to find both halves of the uterus, but it is often not
MORE 1982) were used for this purpose . possible to differentiate between the left and the right

In recent years the imaging ultrasonogra phy has uterine horns. The full stomach and spiral colon often
been used more freq uently to diagnose pregnancies push the uterus towards the right side of the abdomen
(lNABA et al. 1983. BoTERO et al. 1984, IRtE et al. 1984, where it L~ then usually easier to find.
CARTEE el al. 1985, TAVERNE et aJ. 1985, TAINTURIER Restraining methods or sedation of sows arc usually
and MOYSAN 1985. JACKSON 1986). unnecessary during either the transcutaneous o r the
transrcctal scanning procedures. It is also not necess-1ry
to remove the hair in the area where the ultrasound
4.1 Technique of ultrasOnography probe is held against the skin. The sows should be tied
in pigs up or held in a tight chute during the examination. Of-
fering them some feed may distract and calm them.
The imaging ultrasound technique can be used in the
pig by applying the probe to the skin of the ventral ab-
domen (transcutaneous'sonography) or by introd ucing 4.1.2 Transrectal sonography
the probe into the rectum (transrectal sonography)
(CARTEE et aI. 1985, FRAUNHOlZ et al. 1989). During the transrcctal sonogra phic examination of
sows the probe is best manipulated from outside the
rectum after advancing it into the rectum and then r0-
4.1.1 Transcutaneous sonography tated O\'Cr the uterus (Fig. 4.2). Manipulating the probe
with one hand inside the rectum is often difficult and
For the transcutaneous sonographic scanning of the can Stress the animals considembly. In order to be able
SfJW the probe is held against the skin surface of the ven- to manipulate the ultrasound probe from the outside.
tral abdomen, just dorsal to the last three mammary the probe and its connecting cable must be stiffened.
complexes. in the area from the attachments of the For this purpose the probe and the cable arc tied to a 80
mammary glands to 15 em funher dorsally (Fig. 4.1 ). em long guide-rod made from a non-twisting material,
The probe is held in such a way that the sound plane lies such as metal or plastic (Fig. 4.3). The rod encloses the
leve l and impacts perpendicularly onto the abdominal cable and the probe on 3 sides. leaving only the scan-
wall and an area of about 20 by 15 em is scanned. Imag- ning surface open. With the aid of this rod the probe
ing the pregnant uterus is achieved fastest if the hori- can then be advanced and withdrawn or rotated in the
zontally oriented scanning plane is rotated up and down desired direction inside the rectum (FRAUNI-tOLZ ct al.
through the abdomen. Should the uterus not be detect- 1989).

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fill, 4.4: Multiple "'''l'''"' IUlea on an ">c';"':d """'1)' of a,.,.,..', .",~,5,1'ho.*'llT"f'I1oflbelamc'''1i1)'''''''''mcdi".<eann ...
UllraJ<)O"'IP"m pmdOC<'d on , wa'crba,h :~":~'III"l'IOlhal~\J""'4.4 t>.um''''''''''''J'Of1lu\<.o

·l[t.."'·:(),-aJ)-i~)"'lhK\'erailollido."(~IW>"',,# ... ", ,:o."Y"i'h"""",lrorponb"""(arruv.~)m .......·


from&IOIO"""I~ml<)tMuriowybl.ldo:f(lJ)inl""" DayI9o(pn."P""Y.~II)'f'C*IIoicb.ncal""""'''~
U1prot$1""'abuut~~ar. ... _inghtrlitl~r T!1I.....aai dcdinlhc""""h)pcrcdIoicOO'W18flpan:nrn,TnlLT..........
ull~ Uluaillnognrn,

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Omriall stnlClIIres 215

Prior to the trnnsrcctal examination as much of the 4.2.1 Follicles and corpora lutea
feces as possible should be manually relllO'o'Cd from the
rectum. then the probe introduced and pu.<ohcd fOIVo'3rd Follicles are chumcterized by the anechoic follicular
along the rectill floor. If the probe becomes trnpped in a flu id. Normally there are numerous follicles with diam·
rt.'dill fold it may be helpful to initilllly guide it into the eters bct....'Ccn 1 :md 6 mm on the ovaries of so.....s at all
rectum for iI shon distance by enclosing it in a hand. stages of the estrous (:ycle (ScUNUIUUlUSCJI el ill. 1981).
Depending on the size of the sow thut is to be examined. A few days prior to ovulation larger follicles become vis·
its reproductive status and the organ that is targeted the ible, so that during proestrus and estrus SC\'Crnl follicles
probe is advanced to a depth of about 30 to 40 em. The with diameters of 5 to II mm can be found (Fig. 4.6).
dimensions of the probe used fo r this c.umination Confusion can be caused by the presence of hemor-
should not exceed a ....idth or height of 2 to 3 em and a rhagic corpom luteD and Ihe larger blood vessels in the
lenglh of 10 em. Provided the pl Ottdure is conducted vicinilYor the OV'd ries. Cross sections through blood ves-
skillfully there is no need to be afraid of serious injuries sels need to be sonogmphleal1y differentiated rrom fol·
during the examiniltion. licles.
Usual1y most e"~lrous follicles in the pig reach ovula·
tion. Only occasionally do large follicles and corpora lu·
4.2 Ovarian structures in pigs tea occur simultaneously. This may h:Lppcn during the
cycle as wel1 us in pregnancy.
Using tr.msrcctal examinations it is freq ucntly possi- Corpom lutea produce the echo typleal of luteal tis·
ble to sonographic-J.lly depict the porcine ovaries sue (Fig. 4.4 and 4.5). Their sonographic cross section is
(FRAUl'lIlOtZ 1988). The O\'3ricscan also be sc:mncd by hypocchoic. The surrounding ovarian stroma is a little
transcutaneous ultrasonography (MADEC et al. 1988. brighter. They are more difficult to recognize than fol-
WEITZE el al. 1989). The ()V"dries of both, non-pregnant licles. Since the)' lie \'cry close together on the owries
and pregnant sows can be depicted. Based on current their numbers can usually only be estimated (Fig 4.7).
experience. it may sometimes be difficult and take lime Luteinized and hemolThagic corpora lutea can occur
to find the ovaries on both sides of the body. In addi- simultaneously (MADEC et al. 1988). The size or cyclic
tion. when 50......5 are scanned transcutaneously. it is corporn lutea varies between 5 and 10 mm (Sa INURR-
necessal)' to ehange sides. BUSCH et al. 198 1. MADEC et al. 1988). Corpora lutea of
In general, follicles. corpora lulea and ovarian cyslS pregnilncy can be I to 2 mm larger.
can be sonographically depicted. The exact idcntifK:a'
tion and counting of the different functional structures
on the 0\131)' requires practice and may oft en bc possible
only to a limited extent.

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." ~ .3:'~~ "h ..... lllruughth<"",ry"'a"",· ..... h tl&-U:Mu"opIe",,"UiiuI<)*,iaa.,... Tho:~I".1IoI


~.nd~cy.n ~;=fmm2fJ~'-1(lmm.Uh~prooJuctd •

..... 4.• 0:'. uh>(>lo',..,.' .. n<y«<ina'O",Tbe<l>am<1cBOI .... 4.1I: 0',"',"'<)," ..,1II1II"' .....!_I)("'I)1"&_
~moyI()<'AtI1ll1e<ItiO<hJI"4cm.Tr.m""""'!u!'_...... ",Ie< in a __. Uft,~ pI\J<luu:<J In" .... ~

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4.2.2 Ovarian cysl~ may"'~¥O"t""""""r.lftheyal'emult'pIe.",acha


comidenobk size and oa:ur in the ab!lcna: uf>my
In the ~OW anY'~ick larvr than 12 to 15 rnm on the nnrmalfurlC'lionalOirucrul'e'<onlheowrie:'lthcyal'e
.....'aT)'iIi~rcdlobcanovarianC)o$l. C'ysti<; .....'arian ruru.idcrcdl0bcthct:3"""uf~:ticdislurbltl1C!..'ll.
dcgt'lICmlionoccun;ina.ignirlCanlpcn"'Cnlugt:ofoider 'Thc!lon()8raphi<;imageofowri:tn~s;';character
"""""AnincldeOCl:()fhetv.-eenl(landI5%hM"'ptal. i7,c<l by their hypo· or ~ oechoic iRoe. splICe And hy the
«Ily bccnfouml in>l~ughlcrcd""",l (V""'OOI'lA5SCI!E ,i;:corlht:vc:;icular'tructu=.Thcinncrtli~m.:tcrof
",aLI971.EHlI!;k l'l984).c;c,neral1y.lhrec~of ()~t:svarics f""" shout 15 mm 10 lO:v.:ral a.:nlimetcn
C)Sba",d;ff~"'nlialed:l'oIDcular~ ...ilhlnorn.luccnl {f"ig.·UI04.11}.ThcedJogenidlyofthenuilliJNdc
walls and dear "uid com~m.; lut~al cy.<ts "';Ih
a Iu"';n-- follirulart')'5l.~i.<similar 10 thaI !ll:Cn in normal follicle:!.-
i1rowal1that ilia fcwmillimc:tcn thiclc; and hcmor- 1 100tltainsnon:lIcctiom. ln oontntSl.hl'l1lOlTlIagic:~
rha~()'Sbwitha"ron, ....aJlandbloodyruntcnt:s mntain inneredloc!;(Fig. 4_1 I). 'The uhJ8!lOWld ,mage
(Sc..·."UkKlIIJStllClal.l981}.Oiariant)'$UOInbc of l h~OotllCnl$uflk:munhagic<y!olsVltnc. from a kw
found in 1M presence of other follicle! ~nd rorpora rdle<:tionr<lnalraberularnetwnl'k.~rdlectiom
lutea. Iflheyan:si nglclhcyan:11Qt 'le<:(e',Mriiyron. originatclromflbrinandroUu!,'l:n ... hi<:florg<.ni:tcsthc
sidcrc<ltobcintcrfcringwithnurmalfc"iUt),undlht..-y

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tll. 4. 12: r>.()l\i',ogn.m "I",U'{'fTn".~) of'....,.,. Due I" ," t,\&.4.I.l:Cc" ... ul.,.,..· in p~.mIS4d.)'aftcrhc~ flif,lnl
lOtI""", ""'U"'_ ""... "'11It\1...... thmugh tbo t>om are d< "nc "".""d. """u1
l"!1c 'IIIII' au," I.... """".1 QI'IIo
p;c.od il'lllSll-«alwlr2O ... "",m (.rroo»IUNII ...'ndIngoou...-.lml.J\-.;1a1uk.,..,..."....

t1lc. ~. 14 :Pn:p:mt"'CMof._",,[);,y1O.mrl~ f".. 4 .15:I1"'"".nde~(L)m.'..... ""I~·2l ....


"",,'IIO<'hoO:~i<IluI<l"depIc1edill>oolclhc""'",," nail<)' lh<<1IIbr><>·, ....,b" .... ')~mm_T'"
Ium.,,,T~lulu-.- u1t~

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Uterine stmclIIm 2 19

4.3 Uterine structures in pigs of the early conceptus will appear as anechoic areas in-
side the uterine lumen, and they will be surrounded by
4.3.1 Non-pregnant uterus the echoic uterine W'III. If conception has taken place,
one may occasionally sec the first signs of flu id accumu-
The non-pregnant uterus of the pig is difficult to rec- lations between Days 12 and 14 post insemination. De-
ognizc with cenainty_ The uterine wall produces a fine- pending on the position of the uterine horns, the direc-
ly granular, homogenous echo p..1t1ern (Fig_4.12). Due tion of the sonographic plane and the number of con-
to the lonuous nature of the uterine horns their ultra- ceptuses, varying numbers of dark sections through
sound images usually consist of several cross sections embryonic fluid may be detectable (BoTERO et al. 1984.
through the horns. As long as the uterus contains no CARllOE et al. 1985. FRAUl"1I0LZ et al. 1989). Between
fluid it may be difficult to reliably identify it amongst the Days 15 and 20 these anechoic areas reach diameters of
loops of intestine. 10 to 20 mm (Fig. 4. 14). At the end of the third week of
Occasionally the cervix can be seen (Fig. 4.13). The pregnant)' echoic structures become evident inside the
cervical mucosa appears as an echoic line which follows anechoic fluid . These echoes originate from the em-
a winding or eve n zigzag course. This image is caused by bryos and their surrounding amniotic membranes.
the typical pulvini cervicalisorthe pig's cervix. If the rer- Ihe applic-dtion of ultrasonography for pregnant)'
vieli canal is slightly open and contains some flu id a diagnoses before Day 20 of pregnancy is not pr..actical.
curvy, poorly echoic band. surrounded by the more False diagnoses cannot be avoided at thi.. stage. because
echoic ccrvical wall will be visualized. it may be impossible to detect any embryonic fluid in the
uterus of pregnant sows at this lime ( INAUA et al. 1983).

4.3.2 Pregnant uterus 4.3.2.2 Day 20 to 11 5 of pregnancy


4.3.2. 1 Before Day 20 of pregnancy The embryos ll~ually become l\."'COgni1.able around
Day 20 of pregnant)' (Fig. 4.15) and Iheir hean beats
The earliest sonographie indication for the prese nce detectable a few days later (BoTERO et al. 1984, CAR-
of pregmmt)' is the detection of embryonic flu id inside TEE el a!. 1985, FRAUNIIOLZ e t a!. 1989).
the uterus. On the ultrasound image the fluid contents

AvlC ~o zasc ClO oradi ~o


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220 Ultmsmrogmpl,y ill pigs

Fig. 4.16: Ulcrus of a sow on Day 26 of pregnancy. Thc cm· Fig. 4.17: Ute rus of a sow on Day 27 of preg/Ulncy. A hyper·
bl)'O is surrounded by ils amniotic sac (arrow). Its crown· echoic placcnml membrnne (a/TO'NS) is drifling inside the an·
rump-le ngt h (CRL) measures 22 mm. TmnsrectaJ uhrnsono- echoic placental fluid. Tmnsrt.'C{al ultr.tSOnogrnm.
gr.tm.

1-• • 4.18: Ulcrus of a sow on Day 35 of pregnancy. The CRL Fig. 4.19: Uorizontul section through the thorax of a porcil"lC
of Ihe fC lus mell5urcs 31 mm. 1llC head (1-1) w;th both cyes. fc tuson Day 65 of prcgnancy.1llC h)'pcrecooie discs or the rib
front c.rtrem it i~ (a/TO'NS) :md the trunk can be identified. cross sc.'Ctions fonn Ii cone. 1bc hean (ma rked by the crnsses)
Trn nscut:moous uh rnsonogram. lies in the apex of the oonc. Tmnscutanoous ult rasonogram.

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?regl/alll !Items 221

The crown-romp-length (CRL) of the embryos 4.19). Thcy reach a CRL of 50 mm around Day 40 and
measures approximately 8 to 10 mm around Day 20. 100 mm around Day 50 (Ull-REY et a!. 1%5, EVANS
20 mm around Day 28 and 30 to 35 mm around Day 35 imd SACK 1973).
(Fig. 4.16 and 4.1 8). Their trunk diameter increases Around Day 30 the contours of the embryos become
from approximately 10 to 20 mm between Days 25 and evident and the head. alxlomen and the extremities can
35 (MARTINAT-BOI rEet al. 1988). be differcmimed. In the weeks that fo llow several de-
During this period hypcrcchoic ponions of the felal veloping imemal organs can be idemified. The hypo-
membranes can be seen drifting in Ihe embryonic nuid echoic areas of lhe orbit and Slomach, the pulsating hean
(Fig. 4.17). During the funhe r course of the pregnancy and the echoic reflections of the rib cross sections and
Ihe embryos show a veT)' rapid increase in size (Fig. Ihe venebrae are panicularly striking (Fig, 4,)9to 4.2 1),

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222 UilfOSOllogmlJhy ill pigs

)o.g. 4.20: Horizont:.1section through the thorax of a porcine )o.g. 4.21: Transrcctal ultrnsonogrdm of the head in a porciuc
fetus on Day 93 of pregnancy. IJchind Ihe hypcrcchoic rib fetus on Day 99 of pregnancy. The nose points to the left. the
cross st"CIionslic the stom:lch (S) aud the heltn (1-1). Tronsrec- eye (E) lies dorsally and to its right is the 0\'"011 cerebral cra-
tlil uhrolsonogram. nium. Tmnsrcctal ultmsonogrJm.

• 5.0 MHz
trnnsrectal
3.5 MHz
• transcu taneous O. 5.0 MHz
tranSCutaneous

% SO j

Total 1-J 4 S-8 9- 12 13-16 not


inseminated
Weeks after insemination
)oig. 4.22: The accul"lK1' ( . number of correct di ..gooscsln umber of di:.gnoses made)
of tr:msrcctal (5 MHz) and transcutaneous (3.5 and 5 MHz) ultr.iSOflography for
pregnancy diagnosis in pigs (adapted from FIL\UNHOlZ el aJ. 1989).

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4.3.23 Accuracy or sonogr.iphic pregnancy nanry~Atlhis.'>lagcbct><u:n'Jlandllllq,of

diagnOOs d~""creronm.. irrespec!io...,of ..."hethcrtbc ap-


pruach"'a,lransrec.olortnMCUllu.e(l<6andthcfre·
In<XJmp"rIsonlolhepre.iouslyu-.edullt3o;oond q""ncy ..."U3.sor5.0MH,,(H"'U<F~'II.IEu.101U! 1982.
l"",hni'IU"'~'
lhe A·mode and Doppler OIetllnd<· lhe D~lu, etal.l98S).Ovcn1IJ,lhcW!lClusionMnoo.prcg·
imaging sonographic examinatkm pcrolilS An earlier nant"' WMoon~i<lcfCd fC~"bJe frum Week 4 ofpregnan-
~ofprcgnm>eyand)'idu" r.:liatlk: ~lt,(CAR· <)' and the conclusion "pn:gnam" front Wed S. An
'.:J;rtal. 1985.TAVERI'<'Eelai. 1'185). e...rt determi""'lkm of the num~rof rctl$."1 ill not
AOJItIp>tri!lOn~lWttnthel~aland\rans­ poMibk hy ultmonograpby (rl\lST\lRIt:J. and MoYSi\l<
C\l1~neousapprn.>ehesto l""&""ncydiagr'lCl'>isinbn;OO. 1985).
"'II iIO¥oS n:;.oealed that the tr~ns,,:,,'al method off.,r.; 'Ill<: diagno!.llC confi~ncr awriau.'d ..ith ullruono-
more adoant~l.'.'1 during......,o 3 and 4 of pregnancy paphic eumination§ during early pn.1:JUI1k), largely de-
duc to ill hi&her3(nl""'Y (R,. 4.21). Thc accur....)'ur pend!lon the c.".pc"""",, oftbc aanllller. ror ",,,,,ral
aU diagl1(~ e.<tahlW>ed hy Ir~"!n....,tal ~Iillmin"tions pig pn ...1iw il can be roncluded that ~ltra«)nography
during Week 4 c=<kxl 90 % (FRAU~llQU el al offc(S~highlyaccuratemeansrorpregna'''.'ydia~
19119). II ......" u!soshoJo,o,n that tUghcr fn:quency ultra_ from Day JfI after troc lao;( in,."mi"',loo. V~J}'"xpcri·
!WndofSMllzprodoced~aa:uraltresuhstlwt eocedc"'ml""l\ItllIlsomcIimesach~'l:J}'reliabie
the~rfTl'qllCocyof3.sMHl n.""'lbt..: ....-eenl);a)'!<22and24(I" ... IIA1.'1a1.1983.IN'IO
rmmWec~Sthcct.u;o,ofmethodorf~ncy etal.I'Jll.4. T"'''''''Nh1.'1a1.1985. Hcm:ROcLaI.I986.
lwI nosiptifw;anl efi"ecI on the IttIJracy of lhe 1""'- M"'knS"'T-nOt"!l!1.'1a1.1988).

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224 Rt'{tm.'lIca

Rererences to chapte r 4 J~. O. H. (1986); Prqnanty di..,...;. in die ~ ",i,.lUI·time


uIuuonk vannm,. \t"I. Roe. 119. ~I .
SALn, J. M. E. ..... It o. E' ...... ' (t982): Prqnatq di4 ' " in l..iNOM{l. I. L.. J. P. TO'5OI. P. A. ~ and P. J. DzruK (!975):
swiM : A ~ 1:1 the 1eChnique 1:1 m:tal palpMion ..... ulna· Early di4i'C'til rt pcqnanty inlOWlby ultJuonic: llinpIinLd ~ dejAb 1tIIi-
1OWId. Therklp:JIOklsy n. 231-236. lysis. l . Anim. Sci. 40. 220-222.
Bol'uo. 0 .. F. MAmNAY'Borrt et. F. CHe~ (1984): ~ MADEC , F.• F. M.unllAT· Borrt. Y. 1'-oM;arr, M . UI D£MMAY et l,-c.
pr6:Ixc Ik p:lQlion par kho&raPhie d'ultra$O!U.. Journla Reeh . Fur· VAUtII!l.JIT (1988): UliliJIIlion de J'6choiornosraploie en ~1evIae ~in .
dM cn Francc. 16. 181-188. k l. Mid. ~ . &. Alfon Wi4. 117- 133.
BamIo, Q . F. MAmllAY· Borrt ..... F. 8AAfT1!AU (1986): UK l:Iulll'll' MA.....IIUI. A. W. and R. R. AsHOCJIIIiI'I (1967): QuanLitatlYe 01»+:....
IOWId iaMi,. ialWlne bdt' : :Iioa ~pcqnanty and IOI'l1C patboIos). lioN Oil pia: Cllob,)OI ~ knoa'n . . . J• .,ric. Sci .. Carob. ~.
cal eondiIkIns. TlCiiop:nnIncY 26.. 267- m ">-<41.
c...aru. R, E.. T, A , PowJ ..... R, L Ana (191$): U1lAtooOI~K MunMAT-Ilon 1, F.• F. BAarnAu. M . l..utxO. Y. ~ et To-
dncaioa 1:1 prqn&DC)' ill __ Mod. vet, Pnct. 66. 23-26, QUi (1988): L·~d'll\tnton$. Outil dcdi.,......it de .''Mim
famf. W, (1984): Die lysa06c: DcFtc.aion dai o.v. aIs 1eil dai ~ Ia 1f\Iic. Reel. M6d • .-fl, t.c. Allon 164. 119- 126.
AnIIstn".··"p\':7es tcim Schein. \te. mal, DiIt- , OXflc:e. O'Rm.LY. P. J. (miS): ~ dh, __ " in pip by u/tratonit ampii·
E""..,. H, Ii, ..... W. Q SIo: (W13) : PmIaaI dc-..:IOPliiuKI:I ebu.::- tilde dep;h anatyIis. A field co.alilMim. It . vet. 1. 1O, 16.S-161.
Ilk and IabonIDr)' nwnmab; Growth C\l1'\U, alUilal t;:.b'reI ..... f'rN.K . l . and E. WI~ (1981): All early dJa&noW 1:1 pcqnanty
Kle+cled mC:lulCU. Zcntb/, Vel. Med. Reihe C 2. 11-'15, in IOWI by mcaI\J ~ ulirUOiUcs. Mcd)q-r\l wei . 11. 139-1-41.
Fa.uu. A. F.. V, N,:!(IA....nw.c and R. 8, CAUXXI, , (!97l): The com- SoiHtlJ.UlJ5CH. U.. 1. BEIIGfEUl. K.-P' BaOssow ..lid U. KAu ..... f.JII
pithcllllvc UM: ~doppIe( ulin ..... !!..1 in farm animal reprod\lc1iorl. \\:C . (1981): Schcmii Dlf OYattieutl+:i1uns tcim Schwcin, Mh . ~ . Med . 36.
Ree. 8& 202- 205. 811 - 8l5.
Fa.o.tmoou, J. (1988): ZIit Il'&n$ftktalc:n und ItWISbllancn Sonosn· TAnmllJEa , D. et. F. MO\'$AIC (1985): Oiapoaic de: Ja I' ,"'ion par
pIIie inde:r &ynlkoIn&iv'xn O,bl".,it beimSc~;n . \te. rrcd . Dia., ~ie ~ Ja tnIie. Revue MM . .-fl. IJ6" 219-293.
Milnden. T,,\VEa.ICll. M . A . M .. L . 0vtH0. M . \AM LfflsHour and A , H , WII,.
FiAuNHCU, I .• W. KAHN WId W. l.£lDL (19S9): £in \\:lJle:ich lW;- 'IMS! (1915) : Pqnmty ~ in pip: I roeld II1Idy ~
IriIm dt:t tranmktale:ll ulld traM""" lUI SOIqnphie lUI' TrI+::hti&- lincar-.nay lUI·time ulm..... ,nd V'lmli,. and ampl itude: dqItIo-'Y-
keit!d i . ,.... - brim SdI.Cin. Mil. \te. Mcd, 44. 4~1O. As. The VeteriJwy Quanmy 1. 17I-V&.
bI.u>.. T.• Y. N"u7TH~ , N. MATStIf and T. I ...... , (1983): Early prq. UuaIY. D. E.• J. I. SPw.AoIJI!. Q E. Bean and E. R. M,u.u,
na.q di4 _i· in IOWIby u.Ib II "'K I~ ci«tronic 1!CUIIIinI. The- (1965): GiuwtII I:I the _inc Ii:h" J. AAim. Sci. lA, U6- 1I&.
rkrnolOI.,., lO. 97- 0i. V~1. M .• J. SftHCDl"D" WId R. Bounu (1971): Die
I..! . M.. K. 0ttMar0 and S. KvMliOA (1984): OiaanoIis 1:1 prcpancy zyA6Ie EieMIXbOqmmtion bcidu' SaIl . DlIc:h. ticdrUl . Wxhr. 78.
in pip IJy lUI timc: ultrasonic 8-modc JeaII. Jap. J. ZOOIOClon. Sci. 55. ~ -91
381- 388. WEiTZI. K. P.• Q HMilCii:. T. Wil~.MEM and D, RATH (1989): ~.
IsAKCW, D. (1m): Application de la ICCIIniquc uJuuoniquc (Doppler) lion 1:1 IMlIation in the lOW tII:ina Ir'lMcutanoouJ: JOnOSraphy. luehI·
pour un diq:nottie P"!lOl.l Ik ,rwvidili! dai tnliea. Sen-a, An:h . Tier· hyJienc 2-4. 40-42.
hcUk . 1J6. lAS-1.5l

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226 UlITUsollogmphy ill ,logs will etJ/s

t'lg, 5. 1: Sooogrnphy in a standing bitch U!iing a sector scan-


ner. The ute rus lies donial to the urinary bladde r (U),

-
o

"~ag.
5.2: Sonography in 3 pregnant bitch in lateral recumben -
cy using a linear scanner. The uterus, in the lubular stage, lies
cranial to the urinary bladder (U).

Avlorsko zasl!:" eno gradivo


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Techlliqlle of IIlImsollogropi/)' 227

5 Ultrasonography in dogs and cats


The application of sonography during rcproductr.'C quality. Although one could omit the clipping of dogs
and obstetric examinations is enjoying increasing popu- with a spanc coat, this may have disadvantages. If the
larity in small animal pl1lctice. Imaging ultrasonography hair was not removed prior to the examination, in order
frequently offers a suitable alternative to nadiologie-dl to achieve high image quality, the probe has to be
examinations. It can thus contribute to a reduction in pressed more finnly against the skin and more coupling
the technical efforts and safety risks that are as<iOCiated gel needs to be applied. The exccs.'~ive coupling gel is
with radiogmphic examinations. In addition, sono- then more difficult to remO\'C after the examination. It
graphy makes early pregnancy detection JX>SSiblc and is also much more diffICUlt to handle probes with large
usually permits an assessment of the viability of the con- contact surfaces, mostly linear probes, on unclipped
ceptuses, Also in its applie-dtion to diagnose other dogs. Based on current experience dog owners tolerate
pathological conditions of the genital tract ultrasono- the clipping of hair between their dogs. mammary
graphy can be considered equally, or even more effec- glands quite well. Obese .mimais, even if their hair is
tive than other diagnostic techniques (PFoFFENBARGER clipped, tend to provide unsatisfactory ultrasound im-
and FEENEY 1986). ages (TAVERNE et aJ. 1985). In lactating bitches as well
as those with inflammatory or neoplastic changes in the
mammary gland the approach through the linea alba
5.1 Technique of ultrasonography in may be difficult. In such animals it will be beneficial to
dogs and cats position the probe above the mammary glands.
The sonogr.l.phic examination can be perfonned on
For reproductive and obstetric examinations in dogs the standing or recumbent bitch without sedation (Fig.
and cats transcutaneous sonography is used. The ultra- 5.1 and 5.2). Larger dogs should be ex..1mined while
sound probe is positioned externally against the abdo- they are standing. In this position the uterus will lie clos-
minal wall (Fig. 5.1 and 5.2). A transrectal approach, est 10 the ventral abdominal ....'3I1. it cannot easily escape
using small rectal probes adapted from human medi- to a more laleml position and is thus easiest to re:lch.
cine, appears feasible in larger bitches, but has not been Also, animals that arc sick or in late pregnancy experi-
tested adequately in vcterinary pl1lctice. ence the least amount of stress and discomfort in this
Linear, sector and convex scanners are all suitable position. Small dogs and cms arc easily exami ned in lat-
for transcutaneous sonogmphy in dogs and cats. The eral or dorsal recumbency (GONZEL and LONtNG 1983).
usc of 5 MHz scanners in small animals presents a use- In pregnant females in dorsal recumbcncy it should be
ful compromise between image quality and scanning borne in mind that the pressure of the feluses onto the
depth. larger abdominal vc.~'iCls can interfere with circulation.
Of critical importance for optimal image quality is Forced respiration or panting can seriously affect the
the air-free coupling between the probe and the pa- stillness of the image and thus make its interprctalion
tient's skin because hair is very disruptive. Before dogs much more difficuh. Temporarily closing either the
and cats are to be scanned a 5 to 8 em path should be mouth or the nostrils of the dog can reduce the di.<;luro.
clipped betwecn the two rows of mammary glands, ex- ing eITect or respimtory movements, or momentarily
tending from the pubis to cranial of the umbilicus. Even remove them.
in dogs with few hairs clipping will improve the image

AvlC ~o zasc e 10 madi ~o


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228 Ultrasonognlphy in (logs ami ems

fo1g. S.J: Urina ry blad&.!r (U) and non·pregna nt uterus nt the Ag. 5.4: Trnnscut:ml'Ous viI::'>'.' of the urinal)' bladckr (U) and
le.rel of the cc rvi~ (amJl.\'S) in a bitch. Using tl1llL';(:lIlancous the uterus in a bitch examined with!l !'CC\or SC3nncron D'ly 28
sonography ""i th the beam directed \1:nlrodorsally wit h the of pregnancy. Cranial to the bladder is a conceptus (a~'S).
probe npplied to the \1:ntml abdomen, the nm:choic urimlry
bladder will be imaged close 10 the transduce r and the uterus
will lie in the depth of the image.

AvlO sko zast 010 d


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Techniqlle of IIltrasonography 229

In order to produce an image of the uterus the probe echoic organ and servcs as the reference point for the
is positioned tx:twecn the two rows of mammary glands. examination. A full urinary bladder is preferred for
Its beam is directed ventro-dors..dly and it is placed ultmsound examinations. The bladder is easier to find
directly in front of the pubic bone. Following this tech- when it is full and it acts 3.<; an .acoustic window, because
nique it must be remembered that the image closest to its fluid contents will cause the rel3live amplification of
the probe originate from the ventml part of the abdo- the ultrasound passing through it and this facilitates the
men, while the portion of the image furthest removed im[lging of structures behind it. Dorsal to the urinary
from the probe corresponds to the tissues in the dorsal bladder lies the rectum. In transverse section it pro-
abdomen. In contrast to the situation as it is seen during duces [I round cross section with the surface d osest to
transrectal scanning of cows and mares the images seen the transducer producing a bright and conVCl( image.
in the trnnscutaneous examination appear to be upside- Due to the absorption of the sound waves by the rectal
down. During transrectal sonographic examinations the contenL<;, an acoustic shadow usually originates behind
uterus usually lies d ose to the probe and the urinary the rectum and runs into the depth of the image.
bladder somewhat deeper. In contrast, during the tmns- One should attempt to find the pregnant or path-
cutaneous sonographic ex<'lmination of the dog and cat ological uterus in the area of the fundus of the urimuy
the urinary bladder will be d osest to the transducer with bladder (Fig. 5.4). Using the bladder as reference point
the uterus in the depth of the image (Fig. 5.3). A sys- this is usually possible by moving the scanning plane
tematic approach is essential if a thorough examination from side to side. In C'clts, and occasionnlly in dogs, in
L<; 10 be obtained. The sonographic examination of the dorsal recumbency the uterine horns C'cln lie fa r Intcml-
internal genitalia should proceed from C'cludaJ to crani- Iy. They can then be moved into the image by moderate
al. First, the urinary bladder is ide ntified inside the pel- finger pressure onto the abdominal wall.
vis. It produces the typical image of a hollow. hypo-

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230 Uilrasollogroph), in (logs ami eOiS

. , 1 . 1 . , . • ., •• " .. "
tig. 5.5: Sonogmm of a canine ovary with cystic disorder. FI3. 5.6: Photograph oflhc sectioned ovary from Fig. 55 after
1be oval)' measures 10 by 8 by 7 em and contains numerous the bitch was O'VlIriCClomized.
\'CSirula r structu res of v"drying sizes.

rag. 5.7: Sonogr.Jm or an O'VlIrian tumor in a cal. 1lIc enlarged


oval)' (afTU',\"s) exhibits the heterogenous t.'Cq'Cnicity of
mL"(ed tumor tissue.

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Ol.'tuiall S(n/ctures 231

5.2 Ovarian structures in dogs and cats cations for the usc of sonography include ovarian tu-
mors and cysts (PJ:OFFENBARGER and FEENEY 1986,
With currently available ultrasound equipment. $a tMIDTet al. 1986).
diagnostic ultrasonography of the canine and feline Cystic ovaries in the bitch can produce ultrasono-
ovary is largely limited to the detection of pathological grams which appear honeycombed in structure and con-
conditions. Follicles and corpora lutea which are tain numerous anechoic cavities (Fig. 5.5 and 5.6). The
normally only a few millimeters in diameters arc too cysts vary in size. are fluid filled and separated from one
small to be detected reliably by conventional ultrasono- another by thin. echoic walls. Some cysts may have a
graphy (ScHMIDT et al. 1986, PVCZAK 1990). polygonal shape.
In one case of an ovarian tumor in a cat the enlarged
ovary of heterogenous echogenicity was striking (Fig.
5.2.1 Ovarian tumors and cysts 5.7). Large parts of the ovarian tumor were made up of
hypoechoic, solid tissue. In places anechoic. fluid -filled
Some palhological changes on the ovaries of dogs structures were embedded in the tumor.
and cats are sonographiC'd.lIy recognizable. Suitable indi-

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232 U//f'(/IDllagrolH1), ill dogs wzd ems

J.1g. 5.8: Uterus of a bitch around Day 18 of pregnancy. "' be t1g. 5.9: Uterus of a bizch around Day 22 of pregnancy. Two
ulerine wall in Ihe vicinilYof the cooccptus (arrows) appea rs COOCCpluses (!llTo",..s) lie dorsally and cranially (10 .he right
thkkcncd and surrounds a sm:11I anechoic flu id accumulalion or
:lt1d below in the picture) the urinal)' bladde r. The uterine
crnniodo~111y (to the righ t in th is picture) of the urinary blad· wall surrounds anechoic fluid in which e mbryonic stnlctures
der (U). can be seen.

J.1g. 5. IU: Photograph of the c.xcised uterus of a C:lI arou nd


Day 21 of pregnarK:Y. FIVe spherical bulges. eaeh containing
an embryo. are pl\."SCnt.

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Uierine stn /Cll/res 233

5.3 Uterine structures in dogs and cats areas of a fcw millimeters in diu meter could be found in
the regions of the developing conceptuses as early as
Important indications for sonographic examinations the second week of pregnancy (BoULET 1982, CARTEE
of dogs and cats include pregnancy diagnoses and the and R OWLES 1984). It is still being debated as 10
recognition of pathologic-dl changcs of the uterus. The whether these areas represent the lrophoblasts them-
non pregnant, inconspicuous uterus of the dog and cat selves or whether they are areus of edematous swellings
C'd nnot reliably be depicted with the image quality of (HOLST and PII ~lI~R 197 1). Also in the cat it was
currently employed ultrasound equipmelll (INAI!A et al. reported that 2 to 3 mm anechoic areas of embryonic
1984, ScHMIDT el al. 1986). Oa:asionally its sonogra- fluid could be seen in the uterine lumen by Day 11 1014
phic image may be recognizable, but then it is difficult of pregnancy and that the echoes of the developing
to distinguish with confidence between the uterine embr),os were detectable betwee n Days 15 and 20
horns and the surrounding intestinal loops (DAVIDSON (DAVIDSON ct al. 1986).
et aJ. 1986). One exception is the postpartum uterus im-
mediately after parturition. It can be recognized on the 5.3. 1.2 Day 20 10 30 of pregnancy
basis of its size and the identification of its characteristic
placental w ncs. From Day 20 of gestation I it beromes possible. un-
The sonographic features of the pregnant uterus of der practical conditions. to diagnose a pregnancy by so-
the dog and cat are largely the same. For that reason nography in the bitch and the queen (MAIUlAC et a!.
they will be discussed togethe r in the follO\Ying section. 1980. LAIBUN et al. 1982, MAIUIAC 1982, SIIlI.LE and
Particular mention will be made where important dif- GOI\'TAREK 1985, FLOCKIGER et a!. 1988).
ferences between the species occur. The conceptuses which arc filled with hypoechoic
embryonic fluid C'..In be seen on the ultrasound monilor
(Legrand et al. 1982). They arc surrounded by the
echoic uterine w..I1I (Fig. 5.9). The development of am-
5.3.1 Pregnant uterus
pul1ae is characteristic for the stage bet....'Ccn Days 20
5.3.1.1 Before Day 20 of pregnancy and 30. At this time the ampulhle of the bitch are ovoid
in shape. On a longitudinal vicw they produce an oval
If high resolution ultrasound is used it may occa- image and a circular one in a tr.msvcrsc view. In the cat
sionally be possible to detect signs of pregnancy on the the ampullae are spherical at this stage (Fig. 5.10).
ultrasonograms of the dog and cat before Day 20 of When the ampullae fi rst become visible they ofte n do
pregnancy (Fig. 5.8). The sonographic basis for preg- not contain any internal embryonic echoes. Usually the
nancy diagnosi.~, hO\Yever, difficult and'relatively inac- more caudally positioned ampul1ae (nearer the urinary
curate at thi.~ stage, and is therefore not considered bladder) arc easier to find than those Ihm lie in the cr.1-
worthwhile in general practice (MAIUlAC et aJ. 1980. nial abdomen.
H et al. 1986). It ha~ been reported that hypocchoic

I In this chllp1<:r all tllc data on lhe !;Iagc: of prrgnancy "-crr ba!.cd on
.he day of panurition. IIli far IIli Ih is " 'as "1100"11. Day 0 - Day of pan us
minus 63. For the: dog th" approach pmo.ido.he IOO:'it accumlc ~ima·
lion of the aact gatDtional a~-c under pn>l.'licil conditions.. If it ....... im.
~bk: \0 baddulC. lhe day of the filSl !!C,,'icc or ill!!Cmination ...-as
takcn a~ Dar O.

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234 U1tfTUo/logmplt)' ill dogs and cars

14()

120
Longiludinal diamele~
100

E 80
~
E
60

40

20
K
Transverse diameler
o
20 25 30 3l 40 45 50 60
Days of preg nancy
55
"
..Ig. S. I1 : 11lc incrca.'iC:S in the longitudinal and trdrn.verse diameters of
embryonic and fe t:11 \-,:sicles during pn;gnancy in bitehes (rcgres..~ions:
adapted from p.,.CL.AJ( \990).

tlg. 5.12: Tmnsvcr.;c SCCIion through a bitch·s urinary bladder rzg. 5.13: Longitudinal SCCIion through a bitch·s urinary blad-
~it h two bkxxl \'CMCIs (arroo-s) running dorsally to it. Cross de r wit h a blood \"eSSe1 (a~"S) dors.-.11y to it (see also Fig.
sections through blood vessels can be confused ....ith concep- 5. 12).
tuses. Examination in three dimensions makes the differen-
tiation easier by n.....'Caling the longitudinal course of blood
vessels; see Fig. 5.13.

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PregllOnlllfenlS 235

On Day 20 the conceptuses have an inner diameter the breeding date. This can lead to fal<;c negative diag-
of 10 to 20 mm. In bitches they grow to a mean size of noses in cases where the pregnancy diagnosis is pe:r-
20 by 40 mm by about Day 30 (Fig. 5.11 ). These sizes fonned very early. Use of the 1cw.'CT frequency of
are meant to serve as guidelines and may vary consider- 3.5 MHz or less may mean the time of the earliest
ably between bitches of different breeds. The concep- possible pregnancy diagnosis can be delayed by a few
tuses of cats have approximately the same sizes as those days (GONzELand LONING 1983).
of bitches (MA1LHACet al. 1980). In order to avoid misdiagnoses, other nuid fi lled
Under practice oonditions a reliable pregnancy diag- bodies must be differentiated from conceptuses. In par-
nosis using 5 MHz uhrnsound is possible in most cases ticular, blood vessels and loops of intestine that run in
from Day 25 of gestation (TAVERNE et al. 1985, Fl.OCKI- the vicinity of the urinary bladder must be considered.
GER et al. 1988, PVCZAK 1990). A1lhough it appears The cross sections through larger blood vessels adjacent
possible at an earlier stage in some cases it must be TC- to the uterus can appear very similar to young concep-
membered that the breeding date in dogs can differ tuses (Fig. 5. 12). Questionable images should be depict-
considerably from the ovulation date and it is thus diffi- ed in 3 dimensions in order to identify them correctly.
cult to accurately establish gestational age in dogs. Rotation of the transducer will reveal the longitudinal
Matings performed several days prior to ovulation can shape of a blood vessel (Fig. 5.1 3) and the spherical
result in pregnancies. When examined ultrasonographi- shape of a conceptus (Fig. 5. 14). The pulsation of a
cally the conceptuses in such cases will be less developed blood vessel and the pcri"taitic movements in a gut loop
and will not have attained the size expected based on will also aid the difrcrentiation.

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236 UilmSOllograplJy ill dogs and cats

t1g. 5. 14: Ulcm~ of a bllch arou nd Day 24 of pregnancy. Fig. 5.1 5: Conceptus of a bitch around D-JY27 of pregnancy.
M cmbr:mcs of (he yolk s,'1CS can be seen insldc the two em· A longitudinal S«1ion of Ihe elnbryo with its head (H) and its
bryonic \'csiclcs (llrTOl'o'S) which lie dol'Sllllo the urinal)' blad· yolk sac (Y) can be secn inside the vesicle. Ultrnsonogrnm
der (below (he urinal)' bladder In the picture). producW in a watcrbath.

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/'1rgtummmu 237

A £~...., dar" aflcr the amccpluscs bcoxne!WlOO- cclJo.:saheanl'lcal,.ilJbecomedelCCtllblcb.,t""",n


gJ3phicall~visible.~emhryonic~willappcarin_ Oayo;28and30(llQsocsr""'clal.]\III1). Theklcation
side the cmhryouic ,;,:side.. Thi~ will !L~""lIy happen OflhcpulsalingheartCMuidinlhediffereolialioooc-
octween Days 20 and 25 of prcgn""'-y (Fig. 5.9 ind l.........,n yolk sac aoo cmhryo.
5. 14). "Thcsr.:ec/>oMrnnn;pl\SCnttheembtyooro:Jm_ "Thf.:char.....1cm.ic:cresttnl.n.rpeuflhecmhryoand
poncnlSuflheyoiksac(fig. S. IS). lrNdethccmbryonic: its longitudinal hodyaxillcan be r=lV'ilcd oc"",..,n

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I 238 Ullrasonography in (logs (/lid CQts

f1&. 5.16: Feline ronccptus around Day 25 of pregnancy. The


embryo. in longitudinal SCCIion, lies with its hClld (arrow) 10-
wurds the right insKk: the '"<:side. Measuring litc CTl:Mll-rump-
length (CRt) is poMiblc.

180
160

140 Bitches
>20kg
120

E 100
E 80 AU

60
Bitches
40 S 20"
20
0
20 25 30 35 40 45 SO !is 60 .,
Days of pregnancy
fig. 5.1 7: 1bc increase in crown-romp-lengths of canine fetuses in bitches
of different body weights (regressions: adapted from PYC2.AK 1990).

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Preg1l011f ute",s 239

Days 25 and 30. In dog.o; and cats onc can now slart 10 fe:ltures of the pregnant uterus. From now on it will be
measure thc crown·rump-length of the fetuses (Fig. difficult. if nOI impossible, to follow the string of neigh-
5. 16 and 5. 17). Caninc fctuses will have a CRL of be- bouring conceptuses on a longitudinal section of a
tween 20 and 25 mm at about Day 30 (CARTEE nnd single uterine ho m. Due to the strong coiling of the
RO.....1.ES 1984). Felinc fetuses will also reach a size of uterine homs the conceptuses of both horns can now lie
20-25 mm belv.'Ccn Days 25 and 30 (DAVIDSON ct at next to one another in unpredictable ways. Also the ex·
1986). pansion of the individual fetal vesicles shows that their
ampullary shape is disappearing (Fig. 5.1 9). The an-
5.3.1.3 Day 3 1 1050 of pregnancy echoic fluid collections around individual fetuses in-
creases more rJpidly in the longitudinal directio n as
At around Day 30 the fetal vesicles start to elongatc compared 10 the cross section (Fig. 5.1 1). By Day 35 to
and become more ovoid and elongated, both in the 40 they reach inner trdnsverse dinmelcn; of 25 to 35 mm
bitch and cat (PVClAK 1990). The ampullary shape of
and inner longitudinal diameters of 60 to 80 mm
the uterus starts to diminish from Day 35 -40 and (SHIUE and GONTAREK 1985).
changcs 10 a morc tubular shape (Fig. 5.1 8). This will
bring aboul noticeable changcs in thc sonographic

FIg. 5.18: Photograph or the excised uterus of a bitch around f1«. 5.19: Uterus of a bitch around Day 34 of pregnancy. The
Day 35 of pregnancy. At about this time the ampullar appear- fetus. surrounded by the amniotic mcmbr.mc (alT(J\Ol"s) lies
ance of the uterus precedes the tu bular stage. with its head tOW<lrtis the right inside the fetal \-csicle. The
conceptuses assume an OV"".t1shape at this stage.

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240 Ultrasonography in dogs ami cats


t~1g.
..., ... ... ~ .
5.20: l'OOtogroph of a conceptus that was removed from
. .lg. S.2 1: Conceptus of a bitch around Day 35 of prcgnarlC)',
the uterus of li bitch at around Day 4\ of pregnancy. The fe· 1bc fetus lies with its head t~'lIrds the left within the zonary
tus. cnn:lopcd by its allantoic sac (A). is surrounded by the fe· placenta. The edges of the placenta arc curlcd on their mar-
lal component of the zonal)' place nta, gins (arrows) to l"C'i ult in their bowl·like shapes. UltmsollO-
Ilf'JIT1 produced in a ""'lItemlth.

rig. S.12: Concept us of a bitch in week 5 of pregnancy. En-


closed in the zonal)' placenta (arrov.'S) is the fetus (sagiual
section) with its head towards the right; below itlics the yolk
sac (Y).

"
~----------------------------------------------.

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Pn.'gnallf menu 241

Along with the longitudinal expansion of the feta l The fetuses are suspended inside their surrounding
SICS the zonal)' placenta become apparent (fig. 5.20). zonal)' plllccnta (Fig. 5.22). The yolk sac also lies within
In the middle of the vesicle the zonary placenta forms a the 7.on:(1)' placenta. It is ,",,'C II de\'C lopcd in the dog and
cylinder surrounding the embryo or fetus. It i... secn as a remains present until the end of pregnancy. On longitu·
finely granular structure of moderate cchogenidty (Fig. dinal sections through the uterus it can be seen as an ex·
5.21). While the placenta occupies virtually the entire tended, echoic tube. It extends over almost the entire
surface area of the fetal membranes during the early length of the conceptus and thus reaches beyond the
ampullary stage it IlOYI only covers the central area of end.. of the placental bands.
each conceptus afler Day 30. Through their elongation From Day 30 of gestation the contours of the fetuses
the vesicles' ends remain free of placenta. In these areas become discernible (Fig. 5.22). The head and rump can
the uterine wall appears thin. Over almost its whole be distinguished and the limbs are visible as echoic
width the zonary placenta lies closely adherent to the buds. If it is possible \0 obscn'C individual fetuses for
e ndometrium. Only ncar their edges the zonal)' placen. some time one will already be able to sec some active fc·
ta curl away from the endometrium and project slightly tal movements (GONZEL and LONL:-:G 1983, C \R1'EE
into the uterine lumen. On longitudinal ultrasound im· and R OWl£S 1984).
ages of the uterine horns the zonary placenta with their From Day 35 to 40 organogenesis in canine and
bowl·shaped edges can be rcrog.nized. The placenta is feline fetuses has progressed so far that one can rccog·
thicker than the uterine wall. ni7.c deve loping organs inside their bodies. Inside the

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242 Ultrasonography ill dogs (/lid et/fs

fig . .5.23: ]']orizonla] section through a fetus of a bitch arou nd .-11' 5.24: Horizontal se<:tion th rough a canine fetus around
Day 41 ofprcgnancy. The head ]icson the left. Caudally to the Day 46 of pregnancy. The cu rved echo of the diaphragm OUI-
hypcrechoic nb cross sections of the left thoracic waillics the lines Ihat of Ihe liver. The anechoic area in the caudal abdo-
anechoic lumen of the stomach (arrow). me n repfCSCnts the urinary bladder. UltrnsonogrJ.m produced
in (I wa tcroath.

,, T-

,,
t ru nk
l
71
E" II
E

,, Hean ~

,0
Rib with one
, intercostal space

0
w ~ ~ » ~ .3 ~ ~ w ~

Days of pregnancy
Fig. 5.25: Horizontal section th rough a canine fetus arou nd Fig. 5.26: The incrca.'iCS in trunk. bipllricla] and cardiac
Day 46 of gestation. The hype rcchoic rib cross sections of the diameters as well as the length of one rib cross section and one
two halves of the t hor:l~ fo rm a cone shaped plIt1cm. An· intercost:IJ sp.1ce in canine fetuses during pregnancy (regres-
echoic heart chambers can be seen in the apex of the lhora.~. sions; ,Icm ptcd from P'!·O ...... '" 1990).

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Pregl/alll /Items 243

abdomen the large dark area of the stomach L~ easily OESTAMet al. 1983, SIIIU.E and GONTAREK 1985, TOAI.
identified (BoNDa TAM et al. 1983, INAIl;\. et al. 1984, et al. 1986).
NOMURA 1984). The liquid gastric contents are largely In dogs it is also possible to as..'iCS.'I the development
anechoic (Fig. 5.23). Next to it lies the modcrdtely of the conceptuses and the gestational age by fetometry
echoic area of the liver. The next, smaller anechoic area (Fig. 5.26). Thus far data have been collected for the
in the caudal abdomen is that of the urinary bl<ldder following pardmeters: Crown-rump-length and bipari-
(Fig. 5.24). The onset of mineralization of the bones in- ctlli. abdominal and cardiac diameters, as .....cll as the
creases their cchogenicity from Day 35 to 45. The facial size of one rib cross section with one intercostal space
bones (Fig. 5.19, 5.21, 5.22) and the discs of the verte- (CARTEE and ROWLES 1984, PvCZAK 1990). The ultm-
brae and rib cross sections (Fig. 5.25) are the first to be- sonogmphically measured crown-rump-lengths largely
come visible. Initially the sound absorption by the devel- correspond to those obtained after removal of the fetus-
oping bones is so minor that no echo shadows are cre- es from the uterus (EVANS and SACK 1973). The estab-
ated in their backgrounds. lished v:t1ues represent average sizes for different breeds
Both Ixxly halves need 10 be scanned very carefully of dogs. They are intended as guide line values and
if the litter size of a bilch is 10 be determined by ultra- can vary considerably with the breed of the individual
sonography. Counting the number of fetuses <lnd as- bitch. Separating the data for large (>20 kg) and small
signing each fetus to <I specific uterine hom is difficult (20 kg) bitches shows distinct differencc.'I with regard to
on a sagittal CXllmination plane. The transverse section the growth in Icngth of the fetuses. For examplc, the
is more suitable to ensure ,10 optimal orientation and a Icngth of fctuses of large breeds will be about 70 mm on
clear distinction between the uterine horns. By tipping the Day 40 of gestation which is 15 mm more than the
the transducer from the left to the right side and back it corresponding value of 55 mm fo r small dogs. As the
is possible to view bolh sides virtually simultaneously. If use of ultmsonography spreads, it is anticipated that
the transverse view L'I maintained and the transducer is more exact data on the felal growth of dogs and cal~ of
rotated [rom cranial 10 caudal, the number of fetuses the various breeds will become available. Fetal diag-
can be counted most accurately. By continuously, yet nostics, and with them the determination of gestation:!1
slowly, moving the transducer one fe tus after the next age, will then become a great deal more refined in dogs.
will come into view. Even with this procedure errors oc- Very little daw is available on the crown-rump-
cur. The number of expected pups can only be deter- length of feline fetuses (OW.tsn;\NSEN and So~MI OT
mined with reasonable accuracy in small liners (BoN- 1982). They have a mean Icngth of about 3.5 em on Day
OESTAM et al. 1984). In gene ml, the accumcy of the 35, 6.5 em on Day 40, 8.0 em on Day 45, 10 em on Day
fetal count decreases with increasing litte r size (BoN- 50 and 11.5 em on Day 55.

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~... S.19, p"" pattum ut.'t.., """da)' ahcrpartunliQd. One


r>t:>cc~(.1 "to (~m.JW»"''' be r<O>l\"iud in<ide ,I>< u""'"

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www.vet4arab.co.cc I'r.gnanlUlnW 245

5.3.1.4 Day51 lu 65 ufpregnancy TCgaru.lnuJdilion.thcnumber"nJpo6itionoflhcfc·


11l..... shnuldbea........sedduringlhcobsletricexarnirnl·
lnrclativc\cntlS\hcamounloffctalfluiddccrca.'>eS l>on . Sonogrophic <;Canning ,,·ill u<U.allyoonlnbule ';g-
duringtht:la.o;ttrimestcrafpregna",:ywth"tthcfetuscs nirtc:mtlytolhcdccisionastowh<:lhcraC~rcan=.
no looger floa t inside the uterus (Fig. 5.27). but instead tionisimlicatcdornot.
a",onall.;desin~aPl"'"ilionlOthelllem'(lE­ Inlheca",ofa dead fetus a frequem irnp""""'-'n "
(lM!lll l}ClaI.1982).Fctalflu;dcaoonl)·be .. cncranial. thai the fetll< ha.. adopted an unphysinklgicpoMll'" in-
lyandcamJailylathcfctuSl."S.Sinccthcprcgnan<.)"isOOl siJcthc utcrus. Its Iorlgitl.l<liool axis appcars Jistinctly
characterizedb)'lhemntraslbetweentheanechoicfelai bem.lnromparisontolivefetusesthewtlincofd...."J
fluidandtbeeciloicfclalref\cction..in.o;ideil,ilmaybe. one'"'JcAAdis! in<1.l1lec~arSlruc!ureof""fttis"'''"rom­
CQ01Cdilflcuit to Jistingui'lh fetal from matemal ti'iM'cs. pOllentsisalsolo>tin(\eadfet,,:;es(Fig.5.2S).Thiscan~
ncad CO£I<:O!ptu'!CS, in partic"lar. may be overlooked oo.crvoowithio ooe Jay of fetal dcUlh(O"VID5ONCt ••1
duringh""tycl<3lnination.. I~&').
Duringthc las! trimcslcrofprcgnatl()'mo<t fet uses
<,moo( be <lepic,cd in 1010 an the muni!or. N ...... the 5.3.I.ti Postpanum uterus
CI""'.,,-mrnp-~ngthrnaybe<lelerminedbytheaddition
of pan ial measuren .. nt. (e.g. from cmwnlO heart base Afkrparturitionth.... poo1panummcruso(lhcbiICh
+ from heart ooscto mmp) runbesonographicallydepicted.ltislCCnasabroaJ.
echo ic hand "hich mo.'pastlhe urinaryhladderand e ~­
5.3.1.5 0bstetric diagnustics lcndscranially iototh<: aWomcn (Fig. 5.29), h,,,,,o<>-
gJaphic Slru<.1urc consists ofHl1 .... m"ling Hrca> of hypo-
In the oh/ae!rical conten. ullra"'nography is avalua- cchoicandcchoiclis.-;ues, The echoic areas reprcscnt
hie diagnostic tool for the :w;,c~~mcnt offctal viab ility in Ihc brnad uterineromponem,oflhe.il'" oflhe pre
dugsandt"ts(Jol~=elaI.1983.ProFFE."BARCER
,iousplaccntHtion(PnLAJ;l990)
andFH;s[YI9R6,ScHM1DTelaI.191!6)wilh thedepic-
ti<lnnflhepuL"'tinghcananimrorta nlcritcrioninthi,

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246 U/lrrlSOllogralHIY ill dogs and cars

"'ig. S.JO: Embl)'Onic death in a bitt h arou nd Day 22 of preg- n,. S.JI: Embl)'Onic dea th in a biteh around Day 26 of preg-
nancy. The pear shape of the conceptus 10 the right of the nancy. No embryonic Stroctu rescould Dc: found inside the em-
urinary bladder is e\fident. bryonic vesicle (all'O\o\'S). !-"'our other conceptuses did contain
embr)'onic echoes; four In'c pups were born.

Ave 0Z C '10 ClC "


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Uterille pathofogy 247

5.3.2 Uterine pathology vesicles were also smaller than the neighboring, live
ones or WdS to be expected based on the mating date.
5.3.2.1 Embryonic death Apart from the above, oonccptuses al Day 25 10 35
have been seen to oontain no or only small internal em-
()ccm:ionally an embryonic mortality can be sonogra- bryonic echoes (Fig. 5.3 1). When such abnormally
phically observed in a biteh (TAVERNE et al. 1985). The shaped or sized concepllL'iCS as well as conceptuses
resulting rcsorptions may involve individual ooncep- without internal embryonic echoes were follCM'Cd dur-
tuses or the entire liller. Ultrasound examination dur- ing the further oourse of the pregnancy they were secn
ing the ampullary stage of early gestation reveals that to become progressivcly smaller until they eventually
the conceptuses usually have a spherical to ovoid disappeared. In those C".lSCS where an embryonic death
shape. In some cases of embryonic rcsorptions it was had been diagnosed in most C".l.SCS it only affected single
noticed that some embryonic vesicles developed dif- oonceptuscs; the remainder of the litter continued 10
fe rent shapes. Some of them ....'ere obviously more flat , develop unC\'Cntfully.
appeared fl accid and they became irregular in shape.
occasionally developing pointed ends (Fig. 5.30). Such

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248 UllfflSOlIOl,'Trlphy jll dogs ami cats

Fig, 5.32: Pyometra in :1 bitch. Thc utc rinc lumen is dillll cd 10 Fig, 5.33: Pho tograph of a n excised pyomctra of II bitch. The
sc\'c ral centimctcrs. Duc to the very lo n uous naturc o r the utcrus shows pscudo.lmpullll r dilations.
utc rine ho rns the ult rasound beam hit SC\'C ml wall sections
(arTOl'o'S). 1bc ute rus appears panitioned.

AvlO SkO zasc 10 radivo


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Uten'ne pathology 249

5.3.2.2 Pyometra, endometritis, genicity of the pyometra exudate varies between almost
cystic glandular hyperplasia anechoic and moderately echok (KOMAREK 1986,
PFo':l:ENDARGER and FEENEY J986). It primarily de-
An imponan! indication for ultrasonography in pends on the degree of cellularity of the exudate. From
bitches and cats is the detection of pathological condi- a differential diagnostic point of view the pyometra
tions of the uterus. These include pyometra. endometri- must be differentiated from the hcmometra. The ultra-
tis and C)'SIie glandular hyperplasia and their transitional sonogram is not of much help when making the dif-
fonns. ferentiation. The clinical examination has to provide
The recognition of markedly nuid·filled pyometras the conclusive decision in these cases (Sct~MIDT et al.
in bitches and cats is easy (SoiMIDT et al. 1986. PvCZAK 1986).
1990). In ....'Cll developed pyometras the accumulated Pyometras with ampullary dilations of the uterine
Ouid leads to severe dL..tention of the uterus (Fig. 5.32). horns can also be found . These pseudoampul1ae can be
Frequently. the uterus does not produce an image of a single or multiple and uni- or bilateral (Fig. 5.33). Pya-
long, nuid filled tube, but rather shows thin sections of metras with these ampullary dilations can be confused
ute rine wall appearing inside the nuid at irregular inter· with early pregnancies (PvCZAK 1990). When attempt-
vals and creating a compartmentalized image of the ing to differentiate between the two the presencc of
uterus. This image originates from the severe IWisting in embryonic or fetal eehoes inside the nuid will support a
tbe uterine horns. sections of whkh. sometimes com- positive pregnancy diagnosis.
pletely kinked. come to lie close together. The echo-

Avbr koza
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250 Ultrasollography ill dogs alltl ems

tig. 5.J4: TrollJSV(:r.;c sc,",ion through the pclvk area o r a bitch


suffering from endometrit is. A cross sc.:ction through 11 uterine
hom (arrows) is secn next to the urinary bladder. The hom
has a thickened walland contains a small amount of cxudatc.

tlg. 5.35: Ultrasonogram of a bileh ~1OY>1ng gUI loops (ar- fIg. 5.36: Cystic gland ular hypc rptas.ia of the endometrium. A
rows) filled with "'Ulery contents. The nuid filled intestine longitudinal section th rough one uterine hom (UJ'TO\\.'S) shows
must be differentiated rrom :1 uterus :lffeC!cd by inn:lmmatory modcroltc. hypocehoic changes in iL~ wall.
changes.

Av s 0 Z"l~ 10 ra vo
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~.Ia'1\'Crcx:boic:"'r\ld.Ure!lCllnhe:de, Nronallypruduccanultl1l""'lOllrnmsimillU"tn.andea.y
!e<:\cd ins,"" lhe Ouidora Jl)\.'ffietru. l\<.<;uc prr;:."'1ion~ IOwnr"", "'ilh. a I¥JIllClr•. Inc:aseooldnubt it is im·
from the: u!erinc"'3II. wch!l'l polyps and !Um'XH3JI be ponam 10 i&:ntii'y.p",rcrdbiy in CI"OtIS1iC.'C'\ion. rwo fluid
llIeca"""ofsuchimugt$. fllkd lubt!\~1 \h(: level of\h(: HpcXoIthc urinarybiad-
In"","",ofpyOmelralhe utcriocw;tll can he: vcry de •. lk:<c ~"lIn then he mon; ronfidenlly identified R,
!hjn .Qral'l()i>"""n;lyth"'~""d •. lfRnendomc.'tritiswi!h CfOlII~i0n5tbrnugh\h(:Ouidfilledutcrinehorno<.
e:<utIa!","inlOlheu\J.'Crinelurnenis~nt.th<.'u1tf1l· l1lI:abilitytooc-pidC)O>ticglandularhypcrplilSiann
woogrammay.oowar.t>\.'relythickellO.'d, cchoicuter- llf\ult~mdq>end!lQlltheMoflhccndo-­
inewaUwilh tile11Xlf'Oi.'hypocchoiccxudatc,n.;,li.:i" "",lri<l1 rysto and. if present. lhe amount of any ItOCIIITIU-
lumen (Fig. 5.34). eas.". 01 ~n<kImcuit is without any IatcdOuid(»Ycv.o; l990). 'I'btde!«liooolllusmod,-
ck.'aTfluidll(O.J/TIulation!;RredifflCll1t\udiaSJl("'l.'OO !ionisvnlysucce.o.IJ"uJinC«leliof.eYCredegcneratiooof
ullr~ms. lhecnd<'m,,,rium and ... here largcrcy<tO:: !olruclUfC'l an:
Auidfilk:din'''''t;n.1I~/TIuS!bediffen;mia!ed p<C .... n! (Fig. 5.36). 1'bt ch.ange<duc 10 ~"f'IicgWlduJar
(rom pyorn<:tr""(F,,, 5,35). 'I'bt Cllnine abdomcn ron· h),..rpla.iaarebt!\l_nonlongiludin.l~iunsofl""
taininggu! Ioo[>!fiTi<:,lwl!h ,'cryli<juidiog.:staClmocc;t·

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252 Referellces

References to chapter 5 A. FEENEY (1983): PreIIatal indkaton cl puppy viabilily II tcnn.


Compo on Conlinuina fd,.K'IOOn S, Xl13- I026.
KaMAlEX , J. V. (1986) : ~ ~he Dia&note cineI' Pfi'Cllttnl
BoND€STAM, S. . I. AlJTAID and M. KJ.Jtn.i.INEN (l9fl3): Rc.aJ·tilM belm Hu nd . Kkinlier· Ptu. 31. 297- 298.
ullruound prqnano:y d.iagno&is in !be birl. I . unall Anim . Ptta. 24, LAUIUN , c., S. SCilM,pr und J. W. DuDFNl\AllSFN (19fl2) ; &sic: Erfah·
W-S-LSI. rungen mit dem ADR· Rc.aJ·Tlme-Scanner till' 1'rtdItigkeitJd.iagnoIe bel
8om>Es"rAM, S.. M. J{}.au).n'n<, I. AutAID and M. Foa$$ (1984): Schar. Sdrwein. HLInd und KIlle. BeI'I. M ilnch. lictlnl . WsdIr. 95,
Ewuatinf Ille «CUIX)' cl canine prq!WIC)' d~is and linn- size ."...,.
lISi", real-lilM llluuound . Ana ~ . -00. 25, 327 - 332. UOIAND, I . J., B. CAaut:J;, I. BEJ:nAtm et P. F. VtAaD (1982) : lma-
8oIJurt, D. (1982): Applkation de r«tJoc~ all dbgnostk: de p «tqraphique:s de I'ItIIIOnIie .bdotnlnalc des wni_ do.. uli ·
i' blinn cllez .. chimne B~ de ~ilTlaT. SIIII. Acad. vtl . Fr. .H , ques. Bull. AQd . vtt. Fr. 55, 223- 228.
MAlLII.OC, J. M. (1982): OJ'lnostic" de JCSllltion chet ]a dIaue par
229-232.
CAAmI, R. E. and T. Rowta (1984): Preliminary IU>dy cl!be IIluuo-
nogrJJIhie d~clpregnallC)' and mJ de¥e1op'k!llln Illedog. Am .
khosraphie. Bull. Acad. vtt. Fr. 55, 233-236.
MAIUlIIC. J. M . • S. CHAFFAUX. 1. J. lmlAND, B. CAWIll et F. HEITZ
I
J. Yd . Res. 45, lll9-t26S. (19110): ~ de ]a pIIIPMln chez II cIwIC: utilisation de 1'«110- I
CtwmAtUEN , l. OS M. SCtiM/Of (1982): AIdmbesIertlmeUe al fostre graphic. Reel. r.w. ~ . &. Alfon I.S6, 899-907.
hoi hllnd OS Pt. Nord . Vet. Med. 34, 3S4--161. NOMlIlA , K. (r984) : Prqnanc:y d.iagnoIiJ by • rcal-ti1M ulln . Dlllnd
DAVIDSON, A. p' , T. G. NYL-\l'iD and T. TSUlWl (1986): PregI\anty SCIIU'Itr in bitda. J. Jap. vee . med . As5. 11, 140-144.
dQposit: with ultruound in Ille domestic cat . \let . R.cIiol. Tl. 1'oFFE1."IAMllll, E. M. and 0. A. F'aHsY (t986): Use or gny-.we
109- 1\4. ul~ ilIllle l1ia&notis or itproduc:tive di .... se ilIllle bili:h:
Ev.vu, H. E. and W. 0. SAo: (l97l): PreIIatal tlewlopment ~ di;lme. 18 cue. (1981 - 1984). I . Am. I'et . mee!. As5. 189, 90-95.
Slie and Ilbol'1l1o,y mammals : GTOWIh nlfVCS, Qternal feanua and PYczAx , T. (1990): Einsaam6&lichRRn del' Sono&nPhic ill der gynl-
xl«ted rde1enoes. Zentbl. \let. Med. Reihe C 2, 11-45. ~n und geburtshilOiehen Di.-gr..... i k bci HLInd LInd Kaue. Vet.
F'LOcJooEII. M .. P: KltAMEItS. U. Hnn . K. HIJT£II;·W.'5! F' und S. 1JItd. Di$$. , Manchen.
ARNOUI (l9fI8): Fl'1l1Ier&$$llna de, TrklltiJUil bei der H undin. I . vel. SCtiMIDr, S., D. SCHaAD und B. GIfSE (1986): UluasehalJdiagnostit
Mel!. A 35, ~SO 4S4. in der Gynitolosit' belm K1cintier. Tkriml . Ptu. W, 123- 141.
GOmu, A .·R. und I. lCM~ (1983): :z..... edq~hen Ttichti,- SHIl.l.I!, V. M . and J. GoNrAaU (198l): The Uie <:A ultfNOiqraphy
kc:illerkenouna mil dem VETOSCAN Ullruchallgeril - M~i· for preJiWIt)' di'l"'*i' ill Ille bitch. 1. Am . Yd. 1JItd. Au. 187,

..........
ICII LInd Gmuen des Ens'ttes bei del' Hilndin. OUch. JXriml . Wschr.

HOUT. P: A . and R. D. PHEMIfiElt (1971); The ~rmal tlewlophlenl


1021-102!!i.
TAVIiKI'>"l!, M . A. M .. A. C. 0ut!l0!5 and R. "'N Oow (l9fI!!i) : Prq.
nancy diagnolil in !be dog : I ~ bel"" E• ., abc:Iominal pal~
or !be q : Preimpllntllion events. Siol. Rejlioo . 5, 1~-206. and linear·.my TeIl · time «lqnphy. The \\ttrinary QuarlCrty 1,
INAM , T. N. MAl'5U1, R . SIlIMIZIJ and T. IMORl (1984): Uie or echo- 249-U.t
graphy in bitches ror del: :Iion or (MIWion and prq!WIC)'. 'let. Ree. To.u., R. I... M. A. WALKtiJI: and G. A. H£mY (1986): A COiTtpIIUon
ILS, Tl6-m. <:A rul-lilM uJllIIO\Jnd . palpation and rad~ i n prqnancy deICe ·
IotISSTON. S. D. . F. 0. SWrrn. N. C. BAlin!. G. R. JOHSSTON and D. m
lion and liner size detcnnination in the bitch. \let . p .... joI . 27, 102-

AvtorSKO zasl!l e'lO gradivo


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Subject illdex 253

Subject index
Numbers indicate teX! pages, italic Iwm/)en indicate figures with a cenain subject. Letters before the numbers indi-
cate the species: E .. Equine, 8 .. Bovine, OC .. ()vine and Caprine, P .. Porcine, CF .. Canine and Feline.

A
Abortion E 71.
Aea::s.<;ibility E Cii.l.!& B l1l 9.S f.1.l7t 109, 1.S7C OC !.2L M.
AllanlOChorion E ll.. B 119U. 73. 1.99, DC 3.28, - - - Il 100f,
Allantoic - - - I
- fluid E49f. 15.. R 133.210I t 167,2.16! Cotyk:don OC l.l1!..
-sac E49f. l&1 B2.lJ. 12 1. 280. Couplinggel I !.IK9,
Allanlois E ~ 1.61l U:L B Ul. 2 79(. 133. W. 2 161 Crov.1l rump length, embryonic or fella] E 41)(, ~ B 125f. In.
O ' 5.10. 218Z OC 201f, P " I, 4.16. CF 239,1.1.1. 243,
Amniu n E Il. II l1lL. l2.L U1. 2.l!9t 133, W. Z 1M DC 201. Cumulus oophorus 1!2..
flO U 8 P l19. q..
Amniotic - CMlrian see follieular, <MIrian cyst
-fluid E 15... B I3J. L10It J.a l .JtlJ. - endometrial sec: endomelrial cySts
-sac OC l11.. P 4.16, C)'st3dcnoma Jo: .J2. W f,
A mode ullra..«JUnd see ulifll.'\()uoo, " mode C)"SIie oolllus luteum see oolllus luteum ...;th c n ; !)'
Ampullae O ' 233 , ~ 239, C)'Slie glandular hyperplasill CF 249f, 116.
Ane:struo; E 41 ,
Aona, abdominal ~ fC11lS. aorta. abdominal
An ifllC'l IS, liS ,
o
Diaphragm !iCC fetus, diaphrugm
Anel)', carotid sec fetus. an ery. carofid
Diaph)"si~ I63f, 2.159, I..8.l..
- umbil ical §ce fctu.~ anery. umbilical
Didtrus 8 2J...1.ill. 11 3f.
- follicle see follick. d iestrus
8 Doppler ultrasound see ultrasound, Doppler
Biparietal diameter DC m J,ll. Cf' 2:l.1 Double o,'ulatioo see ()\'Ulation, double: ovulat ion
Blastocyst .: ;U.
Brain ~e fetus. bfllin
E
C Ear see felllS. c:ar
Caruncle: B 139, 2. 108[. DC 3.17. 205. ECG DC 3,10.
Catheter . ballooned !L L1ifJ. Echo- see ul\rao;ouoo
Cervical ring! B ~U Echograph)' !iCC SOI'IOgmphy
CeMlt F. u.;U.
8 Bi.llJ. J U. P 2.1.2.1.lJ. Ct' 5, 3. Ectoderm E l.fll..
Cestrian §Cdion 0 ' 245, Ejaculate Jo: ill...J.L
OXlrion E 53. B J J9f. OC l21. Embryo E P M. 491, 1./16, B Y1 z...u. 12 1, 2.11J. i l l Z.B:L
Qipping E I ~ OC 181. Cf 221. Wf, OC 199f. J..l.8. HO(, P 219f, ".m 0' 237f, 5.15[.
ailons ~e felU$. d ilom - ascent E 41)(. 1,61f,
Colon E U. L.Z. P zu. -g.ro">'>,h t; 41)f, B I21.1 25f, P 22 1.
Conceptus E 43f. 1.5?[. 62.12. 8 119f, 2. 73j. - transfe r B 2.103,
- mobmty E 45, 55. 79, Embryonic death E 45f. ~ L11. 62.. 1.95l 1l. B 137, 21().1{.
- g.ro">'>lh E 4Sf, UJ. B 123r. OC 201 , 207, .iZ2. CF m 5.30(;
Coma: scanner n. H!1. m Endoderm P/, 61,
eo""" Endometrial
- albicans B 21. - folds E ;ll.Llfl.62. I/o1 I/O! n f, B 1ll2.lll 1...ll. 295l
- hemorrlulgieum E 29{, /.17(, P 2li. OC 199, i l l
- luteum E ill. I.IIC B II 9S f, 215C Ul2. z..H.. OC 191. 3.5j. - cysts E ~ m. L 'll. ll.:a LI Bf
P ll~J4t Endome trit is E il 7S f. B 139f, 2 Hlf, Ct ' ' 49f 1.l:L.
E 31 f.
- - ao:c'S/iOI)' Endometrium 1' /.6, o!1.. /.47C 62..1l. 1.l 05C B II Sf, i l l l!L
- - growth B 21. 103f, 2. 4J{. Epiph)'si!; lIH,
- - of pregnancy E zz.:ll. 1.19{, B 2:12..!! l.1Z. 10l f. 241(; Estrus E 19,33,41, B 93f,113f,
P 4, 7, - secre tion B 11Sf, 267t: 1..!..L
- OC Zll2.
- pt:1"5t.\lrng E;o:lremily. froll t, hind !iCC felus, ~I""m ily
- - regre.o;sing E ~ 1,1]£ B 2.J2. Ere !iCe fel us, eye

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254 Subject il/dex

f _ omasus B Z 1/4
Fab: ~~bri sec felllS. falxccmm - oWf>e:ltion 8 122.291. HL mf. 2 /J"f. Q ' z:u.
Fem ur !iCC fetllS, femur - OMium intl'llOlminale 8 ..!. U7.
Fertility B IOH, - palate H I49. 1. 127f,
Fetal - pekis t: ~ fl l 6.1.21S1f. l ll 2 1 U. I
- dclllh see cmhl)1)ni(: death - penis B 1m.
- macenuion B lJl. 21!lZ - phalanI 8 iti.l .l, I.U l . tH.I.
- mummirlClltion 8 111 1.. 1iM. OC m - pituitaI)' B 1.11Jf,
- pulK1U~ E S7f. - plexus choriodc:i B 149.
Fetometl)' I-: 65 f, L 21f. B 1m. 2 1N[. OC 2m . c t" 243, - position o( H ill
FeM ~: a.
1.69(. 61f. U?lC B 143f. 21 n t OC 2mf• .J.l }(, - p ft'put"C 8 Ih9.
p 221. CF 241f. 5.21[. - radius H 16). 2 1$", uu.. I
- abdomen ~: ~ /.ffi 8 122,1. W I. 173. 2/ll. - rib 1-: 61. [.8 /.91. 67.1.91 U li1. 179. 218I. OC m J .Z7.
- age de termination I-: 65f. 1.91t 8 I 75{, 1.11l7(. OC m P 22 1. 4. 19f. CF & 1.ll.
- MJr1Il. alvloolinai B ~z. I44. - OImen 8 1.147, OC ~ ,
- IIrtel)'. camtid 8 I..ll. - scapula II 2. 1j.I. I..8.l.
- ariel)'. umbilical t: ~ ld12. 8 1M. l.61. 2.16{. - sphcnoidc bone 8 2112.
- brain B 149, - spinal cord ): f...& B mf. },/ 16
- - cav: t: hl. UU. ~ 1.9/l 8 1.11& 147(, 2./21{, I.1l. l ,m , - stomach 1-: !!.l1...M. i l l !!1 B 159. 1. 145C Il1 OC J:l&
OC mJ...ll P 4.21, P 22 I, :I.1D. Ct· 243, HJ.
- ctrt:brlll ventricle B 2122 149. 2.fUf - tai l 1-;61 . H m.l.l3&
- d a.... B 16S, 1. 156(. 1.163. - tOlnk E J..&!. ~ l.!l.J... !!1 L!H B m.. 179. 21 m P :uI.
- dims B 169, ct' 243,
- corpus mamma~ 8 2. I25f - umbilical cord E 5 I. 1.67, I. roo63. n. B 1;:9. Z. 94, 167, 1. 160(,
- diaphragm U 2 /oIJ. l ~ 2. /oIJ, O · ll:!. 179.
- car B 15 1, 2.IJ1. - urinal)' blaMer 8 Z!.1.!.2:f.
- w~mjty. fllJf1t 8 ll2.1.!!J. 1M 11541. I..H.l... OC .!.l.i 2(13, - !iCJl)Ium E 6.1
P " 1,:1. 1& - Slemum 8 1.139, uz.
- w~m ity. hind B J.22. z..u
1M. 2 /58(. W. OC J.ll.;m. - 9I1cus 5plcnialis B 1.125t
P 221. - tCBIll B 1691, 1.166f,
- eye (~) 8 I..:li. 1. 11 71 J..1i. 2 J741. - Ieeth U I49, 2. I27f,
OC l!I.l. - lc::SIis .:& B llL 1.li'Ot
- - lashc!l - IOOr.u: t: 61 U!A 6Sf. 1.9(}. 8 In. 2. U 21 111 } IU OC
- - lid 8 UJ.
- - lens t: 61l..B:l. ~ 1.1I1i1. P4.11Jf,
- fab: ccrcbri 8 2. 122, 1:!2. 1. IUf - tibia H IM .1. 15l!. 11!.l.
- femu r B IM. IRI, 2. JSS, - longue 8 !5 J. 1.1 xr.
- gcnitalt ubC'rck E U B 1691. 1. 165. - trachta 8 U1..2 U O,
- pouolh B Tabk 1. I. 1. 1.81f, - ulna 8 16J. 2.Ij", IRI.
- head t: 1.69[; 6.5. [.g], B J.22. 1.9Jt I..:li. Ul lll2 OC J.ll. - vein, call(b,l CII\-al E 1.&1 8 1..UJ,
p 221.ll1l. l.lL O · Z!l. Ul. - .'rin. umbilical E 6.1 L1J!l. U 1('7, 1,161.
- heart E 61 . LB6. B l U Jf L59.. OC )'1", P 221. "./1r, O · .t..,U. - ''encbrae E 6:l. L1lJ. 8 mf. 2.JJ"C 179. }, I 8l. P 221. cr ldJ,
- - chambl:r I-: 6.L L86. B U2, 2 /.u, - venehral
- - rate t: 6LUl.62. B I..11.!n. 1. I Z6. - - art'h B IS3f,

t:~'~.~IS~'~.. l S I.
- - body B 153f. 1.IJ6.
-- hume
- ,'alve!;
rus 8 - - column .: 6.l. B In r. 2.IJJ~ OC 20). J.Z9t
- h)'J7OthBlanlllS - \'Uk'3 R It!2.
- ilium U FlXlltion OC Il!2. P 211. CF lli
- il l Foal heal E 7If, I/O{
- intCSl inc Follidc E 15f. l.PJ. 8 891', 1. JJC OC 19 1f. OC I..2L lZ !!!f:.
- ~jum 181. 2.lS1. P 2.1.S.M
- kidney - anD\wtoric t: 33f. J.JJC
- Ial)= - diel;tros 8 93. 1.18l
- liYcr I-: &LM. B 1212145. OC :!.1:L J..2l1 J..J!l O · 2-13, - dominllnl E 1..2. L1.Z. B 2J.2.l.L
- luII& B 159. OC l..22" - during pregnancy E II B 2J.
-l1l8JIdibk B In. 2. 11/, 2. 119f, - c::SIfUS E !.,2f" 1..2. l.l1{, B1.1 J{. 93f. 1.1:I. OC 191 r, P zu.
_ ma;<ilta 8 Z 1ZI 149f. 1.119f, - gm"",h t: 19. 1.12. B 93. 21/,
- meUlCarpus D 1!!,1 z' l54f IRI. 1.l& - hclnOffhagc t: ll. LU ll.. l.JJ.
- rneUltal'Ml.' 8 1M.1.JJ8j; W. 2/&i - hemorrhagic E 33(. Lll.
- mouth B 149. 1.117f, - luteinizing E ll /.JJt
- n:w.1 bone K ! 51, 1, 1,11, _ melc:st1US H 93 , 2 17.
- neck E 6l.. L1lJ. U 2.140{. - pr'CO"ulattn)' E 1.2.
- ~ B 149f. 1. 11/if: - proestrus K lU.l....U.

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Subject imler 255

- punclure E 23, I, lSI.


- shape E 12, 1.14[. B B2,
- size E 19, ill B 9 1f, 2. 12f,
"
MltCCration sec fetal. maceration
Mandible sec fetU$, mandiblo:
FolliculH r Mwcilla !iCC fetus. mwcilla
- antrum E lL 21. B !!9{, Malian so:ction 143. L l1(!,
- cyst t)"St B I01f,1,49f, P 211, :L§£ Ml:5Odcrm E I..&.L
- nllid E Metacarpus !iCC fetus. metacarpus
- luteal C)'St Metatarsus !iCC fetus, metatarsus
- thecalqst B 107f, 249f, Metestrus 8 9H.2/7, ilL
- wall t: 15, 11.21. 8 891.2,13,219, Muoomctr.l t: 11. L LlL OC m
- wa\~ 8 93.212[. Multiple pregnant)' OC 199. 200.
Frontal S«1ion 149, MummifICation sec fetal nlUmmiflCalion
FSII OC J,9, Myo metrium E41,1.47[' B I17.

G N
Genital lubcTrlc: !'oC:C fct~ genital tubercle Neck see fetus, neck
Granulosa cdl tumor E 37, 1,17[' B ill , 1,S9/. Nose sec fetus.. I'IO!Io!
G~'lh retardation B UI. Nuclear magnc lK:: resonance imaging 123.2.83. 1,97, .1.19.
Gut see intc:stillC
o
Obsteulcal cxamination C~' 245.
H OMiflCation sec fetus.. ossi fICation
BOO ll!S.. OYarian
!iean !il:e al'iO fet~ hea n - hem atoma E ~ 1"J6,
- adr.'ity, embl),onK:: E 49, fi9, 79. B 121. 125, 137. OC 199.
- !Umor ~: 37f, 1.37[. B Ill, 1.59f, ct' 231, .tl.
e r 237,
- C)'St E 39. 1,4J[. B 107f. 2.49[. OC 191 . .!.& P 217. 4.8[
Heat sec eslrus Ct' 231, 5.5[
Hind extremity see fetus. extremity. hind OYarieaomy E 37.
Horizontal S«1ion 67. 143, 2116, 0Ya1)' E IS, B ~ 89f, 211[. OC 19lf, 3,5[ P 21 5f. H C
Humerus ~ fetus, humerus Ct' 231. 5.5C
HydraUamois E l l. L2& OC209. J. ll. Ovulation E 19f. !J2121. 8 91 f, OC 193. P 215.
Hydmmnion E 1 1. L'2& OC m - doublo: (MIlation E !2. I. /.J. 3 1. 53. 55.
Hydromctr.! OC 207f. J. ll[.
Hymen. pe~ent E !L Ull. p
Palate sec felus, palate
I Paramedian 5«1ion 143,
Ilium sec felus, ilium Panurition E 61.
ImpcdllllOC L l. Petom sc:c: also fetus, pelvis B ~ 2.6f,
Impbmation E <1.5 • .51, 79. Penetration depth 87.111. 173.
Inguinal gland OC 189, Penis !iCC fetus. penis
IntC$line sec also Fetus. intestine CF 235, 251, 5,35. PGF sec: proSlagiandin
- wall £1. 7. Placenta C F 241.5.11[.
[odil1C solution B l:!.L LJ 14, I'lacentation E ~,a CF 245. ,U2.
Ischium ~ fetus. isctIium Pl:tCCnlomc B I ll. 292, 197/. 133. OC 199. 1./.2, 205. l 29f.
Plcl!us ehoriodei see fetus, plexus choriodei
I'MSG see ECG
J
Position see also fetus, position 159
l'osIerior pn.:!il:ntation 159. 173, 2./73,
K I'ostpanum period 8 139.1.108[.
Kidney !'oC:C fetus. kidney Preputt see fet us. prepuce
Proestrus B 93, 11 7.
L I'roge:o;lemne E 33, B l05f.
lAIynx see fetus.laryru: Prostaglandin OC 193, J. 9f, Z!!2. 134.
uucocytes E L I Q9, Pregnancy
Unearscanncr g Slf,2.lf, 187, 227. - age determination E 65f. 1.911. B 115f. 2.187[. DC 203,
l.ivt:r sce fetus.lM:r - diagnosis. sonographic
Lochia E 7 I f. 1.1()()f, B 139. 1.1Q9(; - - aa:urrdC)' E 43f, B I ~ OC 187,207, r 223, 4.22.
Lochiometra E ll,l. IOl. B l.lIl, - - lime or E 45r. 8 I ~ OC 201f. 2OSf, P 22.3. ct' 235,
Longitudinal !iCCtion 143, - disorder Ell 1,98[. B 137. 2.J04f, DC 200. CF 245. i l l
Lung sec fetus,lung Presentation. anterior 159. 173. 1.173.
Lutcal tiSMlC ~ 95r, losr, Punclure
Lutcinwtion E ll. 33.1.11[' - de\o;c", E a LB!l.
Luteol)Sis E ~ B ~ - of felus sec letol. punclun:

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256 Subject inda

- of follides sec follicle. puncture U


~Ira E n. I. J09f, 8 14 1, 1. /J5, OC 201f, .til. CF 249f, Ulna see f~lus. ulna
5.31t Ultrasound
- absor-p(ion U. 65, 131, 141. ISS. 163.
Q - A mode 181.201. 213.
- Doppler 181, 2Q1, 2n.
- enhancement ISf. I.8/.
R - examination :ICC iIOl'lOgIlIphy
Radius sec felllS, radius - frequency 17. 25, 43. S 1, 87f. 2. 9f, 125. 287[. 131. 181, 201. 223,
Rcflenioo ~ i l l 131, _ gel seeeoupling!,'C1
- 1'C\'CmeTluion 8S, l Z - impact 1.Sf. ill
- specula r rclkction 45, 12. - ref1cclion 1.7, ~ 163,
- wrfac:e Ii. 125, - shadows IS f. I,Bf, 1,39. 6\. ISSf. ll1.
Ra;tal examinalion Ell , Z2. 8 83, - "'-ave !,~ . 87.
Rectum E lL B 83, ct' 229, Umbilical cord sec fetu.~ umbilical cord
Reo;oIution 871,29f, Urinary blaMer ~ also felll§, Urinary bladder Ell . 1,2. 1.1.
Re5OrJMion sec embryonic dealh n , 1.110 B SS. 2 5f, 2.13. OC lIN. J..J..!!l. CF m 5,3t
Rc-.'Cmcralion sec relkctioo, l1:\'Crbcration Urine E 11. /.1, 1,3, n .
Ru men sec felllS, romen Uromctra E n.I,IIl.
UtelU5 t: 41 f. B l13f. OC 3.1f, 195f. P 219f. 4,1lf, C t' 5. 3f, 2Jlf,
S - infusion t: 15. 1,108.
Sagittal settion 1J. 2.2.I43, 2tt6, - non·pregnant £ 41f. 1,47/. B 22j. IIJf, 2,{)1f, OC 3,3[ 195,
Sec!or scannc r 1.3, 83f, 1.3f, 1lJ. l61f, 143, 181, 221, J. lIt P 219. 4,1l{; Ct' 5,3. 233.
So: dc:tennilUllion . : 6J. B I ~. - - during3na11U5 £4\.
Scanningwidth B 131. - - during dic::sllU5 E 41. 1,47. B 113f, 261. 2.66.
Scapula !ieC fetus, scapula _ _ during $1\15 E 41, 1.48f, 11, B 113f. 2.62. 1.65• .?67f,
StmIum sec: felus, !crUmm OC 195. 1..1.Z.
Shadowing sec ultrasound shadolo.'S - - during postpanum period t: 1\f, / ,JOOf, 8 139, 2.JOSf,
5ooognIphy, ledmiquc: of CF 245. 1..Z&
- Ir~lJ1neouo; £. U. 65. OC 181f. U 201. P 213. 4.1. 223. - pregnant E 4Jf. 1.5l:f, B 2.38. 119f. 2. 73f. OC 191f,J,JJl P 219.
O · 221f. H f, 4. 14f, CF 233. 5,Bf,
- lransrectal t; II, U 65. L!l!1 B 83 f.2/f, OC 181f. ,1.2 201. Uteril'lC
P 2m. 4,1. 223. - body E lJ. L.1 45. B 85.
- lr.. nsv-..ginaJ E ,t!. L I..!!. 571.1.80/. - oompanIDC'nl5 B I ~ Il l, J..95f, OC 199. J.l6f,
Sound lICe ull~nd - cu,,-alure
Specular reflection sec re lkClion. specular rdkdion - - large B 2.2. 1U 2,61. 2.6jf, 2 75. OC .!:L. 195.
Spinal cord St.'e felm. spinal cord - - small B 1!1. 2.61. 26j. 2. 75. OC 195.
Spoir;e ,,'hccJpanem E4 1,/,48f, - hom E !1. 1,4f, 1.47[. 45. B 85. I \3f, 2.61f, 2.69f, OC 191.
Slem um 5CC fetus. iIIcmum - lumen E43. 15, B 1IS. 121 , 131. 2.9S/. OC 19S,
Stomach lICe felus, iIIomadi - wall E4S , J.j& 12. B lISf. 2.61f, 131 . }.9's/. OC 195.
Superovulation B 91 f. 2. J9f, 101 . 239. OC 193. 3.9f,
V
Vagina E n . BSS,
T Vein. umbilical fetus, \'C in. umbilical
5ee
Tail sec fettK, lail Venebral column see (e lus, \'Cnebnll column
TesticuJardc::scem .: 63, 8 11 1, Ven ical scction B 145,
Testis 5CC fetus. lesti5 VeMibulum B SS.
Thorall see fetus. lhorall
TIbia sec feltK, libia w
Tongue see fetus. longue
TndIea sec fe tus. tradlea x
Tnmsverscposilion 2.1 73.
Transvcrsc SCCIion S3. H/. I U. }.61f, V Ol 143. 2.116. y
Trophoblast OC 191. Yolk sac E 49f. 1.6Jf, L74, CF 237. 1 15. 241, i l l
Twin pregnancy E 31. 45. 51 f. L 7Jf, 12. B Ui. 2103. OC 3.21t
201. z
- Ifealmcnt E 55, Zonary placenta .scc placenta

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Veterinary Reproductive Ultrasonography covers all


of the most important domestic large and small
animals and is a comprehensive and uniquely
Illustrated account of veterinary gynecologic
examination and reproduction. Commendng with
the common indications for ultrasonography.
gynecologic and obstetric examination. the book
mo"e5 on to interpret ultrasonogfaphic findings. The
pregnant and non-pregnant uterus. pathologic
changes of the uterus and other abnormal
ultrasonographic findings are desaibed and
--
• •

explained.
This comprehensive guide to horse. cattle. sheep, I
goat. swine, dog and cat gynecologic examination
and reproduction explains technique as well as
intetpietation.lts extensive i1Iusbation provides quick
acce1S and answers.
IIrterinary Reproductive Ultrasonography. with i1s
nearly 400 top-quality illustrations and descriptive
legends. is the definitive guide to reproductive
problems facing the busy practitioner in day-to-day
proctice.

ISBN 3-89993- 005-3

A
by Dr.Stator & Saraajka

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