One of the complications of Twinning of mono chorionic mono amniotic gestations is conjointed Twins. Structural congenital malformations occur in 5 % to 7 % of twin gestations versus only 3 % of singleton births. Most defects occurring in only one of the twin fetuses. Occasional anomalies such as omphalocele sincenomalia heart defect one reported in both concordance. The structural defect commonly associated with monozygotic twins included conjoined twins: extrophy of bladder, vertebral defect. trachea esophageal fistula with esophageal atresia anomalies (VATER complex) anencephaly. Congenital heart defect and holopro cencephaly. The incidence of con joined twins is approximately 1 of 50000 70 %-75 % are female. The classification are 1) thoraco pagus: jointed at the thorax. They may share the chest and upper abdominal organs. This is the most common type (70%). 2) Xiophopagus on omphalopagus: jointed by the anterior abdominal wall down to umbilicus 3) pygopagus: jointed by the sacrum and coccyx lying back to back. 4) Ischiopagus: jointed at the ischium or sacrum lying side by side. 5) Craniopagus: jointed at the cranium lying at right angles each other. The sonographic role of management of conjointed twins is to make diagnosis and detect associated anomaly and the extent of joining of twins and map out the defect and determine the likelihood of post natal viability.

Background and Aim: This study was conducted to compare the sonographic (gray scale) findings with those of Doppler SONOGRAPHY in patients with rejection of kidney transplant.Material and Methods: This was a cross-sectional study performed in Hasheminejhad Educational and Therapeutic Center in Tehran. SONOGRAPHY and then Doppler SONOGRAPHY were performed and primary creatinin level and if needed sequential creatinin levels, were checked. We used a scanner (AU4 mod) with 3.5 and 7.5 MHz probes.Results: The most common morphologic signs in SONOGRAPHY were increased antroposterior diameter of allografts in 19 cases (31.4%). Other common morphologic signs consisted of increased cortical echogenicity in 18 cases (30%), increased prominanance of the renal pyramid or hypoechogenicity of pyramid in 12 cases (20%), decreased echogenicity of rejected kidney sinus in 7cases (7.11%). The rarest morphologic sign was focal cortical hypoechogenicity in 2 cases (4.3%). Thirty one patients (51.7%) had positive sonographic findings, 47 patients (78.3%). had Resistive Index (RI) ³0.8 and 13 patients (21/7%) had Resistive Index ³0.9. Those with age range of 51-65 years had the highest frequency among all the patients and revealed positive findings in both methods of SONOGRAPHY. In 23.4% of the patients creatinin level was normal. 46 patients (76.6%) had early and fourteen other patients had late onset rejection of the transplant.Conclusions: Doppler SONOGRAPHY (RI) is the best and most sensitive non invasive method for precise and early diagnosis of renal allograft rejection. (RI)³0.8 has eliminated need of taking biopsy. Findings of SONOGRAPHY were less sensitive than those of Doppler SONOGRAPHY.

Introduction: Pelvic relaxation and cystocele is a common problem in middle to old age women. Transabdominal ultrasound (TAS) is a noninvasive, available routine procedure in many situations. We evaluated whether TAS can predict pelvic relaxation or not.Materials and Methods: In a cross sectional case- control study one hundred women 30 years or older were enrolled into the study. An expert female urologist examined the cases for the presence of signs and the grading of pelvic relaxation. A single radiologist blinded to pelvic exam results performed TAS. In the full bladder state the following criteria were recorded: 1. Bladder outlet funneling at rest and valsalva 2. Bladder base position in relation to the superior edge of the pubis symphysis 3. Bladder wall thickness 4. Pelvicaliceal system stasis 5.Post voiding residual urine (PVR).Results: Bladder outlet funneling can predict pelvic relaxation (Se, 91.3%), both at rest and after valsalva. If the bladder base descent is seen below the superior edge of the pubis with the cut off point of 5 mm,it can predict pelvic relaxation.Conclusion: TAS can be used as a safe and available modality to predict pelvic relaxation.

Background: SONOGRAPHY imaging in emergent situations is of easy-access with an ever-increasing demand. The aim of the current study was to determine the justification of SONOGRAPHY in emergent patients at a tertiary provincial referent medical center in a one-year period. Methods: In a retrospective descriptive cross-sectional study, 400 emergent patients underwent SONOGRAPHY imaging during the year 2017 were selected using systematic random sampling method. The data of age, gender, anatomic area, SONOGRAPHY number, Focused Assessment with SONOGRAPHY for Trauma (FAST) SONOGRAPHY, and diagnosis were extracted from patient profiles, and were entered in a researcher-made checklist. Data analysis was performed using descriptive statistics and chi-square test. Findings: Men patients represented 60. 0% of the requested SONOGRAPHY cases, and 40. 0% of the exams were performed in the patient at the age range of 20 to 40 years old. 73. 0% of patients underwent FAST SONOGRAPHY, required subsequent diagnostic SONOGRAPHY investigation, while FAST SONOGRAPHY led only to a diagnosis in 50. 0% of the patients. 63. 5% of the patients underwent more than one repeated SONOGRAPHY investigations. Conclusion: Diagnostic efficiency of FAST SONOGRAPHY was found to be underpowered in the current study. This caused wasting the resources, as well inflicting diagnostic retard in the emergent and urgent setting. The training of FAST SONOGRAPHY needs to be reviewed and revised, regarding its rationality and appropriate implementation.

Fetal reduction is suggested in multiple gestations (3 or more), when the number of fetuses endanger the delivery of the other fetuses or endanger the health of the mother and after chorionic villus sampling (CVS) in multiple gestations when one of the fetuses  has chromosal abnormalities or thalassaemia.In this study, under the guide of SONOGRAPHY, 65 mothers with multiple gestations underwent selective (genetically involved) or nonselective (multiple gestations) fetal reduction.The gestational age was between 9-12 weeks, with no injection of any substance (KCL or hypertonic salin) in order to reduce complications. We used the traumatic method by targeting the fetal heart with a spinal needle under sonographic guide. We had minimal complications and follow-up SONOGRAPHY revealed the normal growth of the remaining fetuses.

Background: Glucocerebrosidase (GBA) mutation is the most common genetic risk factor in Parkinson’ s disease (PD). Transcranial SONOGRAPHY (TCS) shows increased substantia nigra (SN) echogenicity in both idiopathic and genetic forms of PD. The goal of this study was to compare maximal area of SN hyperechogenicity (aSNmax) and diameter of third ventricle (DTV) between GBA mutation carriers and healthy controls. . . .

Graded compressive SONOGRAPHY may be useful as an adjuvant in the diagnosis of acute appendicitis. To determine the role of SONOGRAPHYin the differential diagnosis of acute appendicitis, preappendectomy sonographic data of 164 consecutive cases in Fatemeh-Zahra Teaching Hospital were evaluated. Of 113 (68.9%) patients who had acute appendicitis in histopathology, 64 (56.6%) cases had preoperative sonographic diagnosis of acute appendicitis. Of 51 patients who had normal; appendices, 40 (78.4%) cases had normal appendices in sonographic evaluations. Sensitivity, specificity and accuracy of SONOGRAPHY for acute appendicitis were 56.7%, 78.4% and 0.63, respectively. The positive and negative predictive values were 85.3% and 44.49%; respectively. As a result, sonographic evaluation is an additional diagnostic tool in acute appendicitis.

Ultrasound is the method of choice for many inter-ventions, especially in the abdomen, mainly because of the real-time visualization of the procedure.Most of the liver masses could be precisely localized and biopsied under ultrasound and different methods of tumor ablation which could be performed with ultrasound guidance have been introduced. However, there are some small hepatocellular carcinomas or metastatic lesions, which are well seen on CT scan images but could not be proficiently localized with SONOGRAPHY.Fusion of CT or MR images of the abdomen shows the lesion. Ultrasound imaging is possible in a virtual navigator system in these cases in which biopsy or RF tumor ablation is possible with US guidance.In this presentation, the method of image fusion and some interesting cases are discussed.-Fusion of CT or MR images of abdomen, which show the lesion, and the ultrasound images is possible in a virtual navigator system in these cases and biopsy or RF tumor ablation is possible with US guidance.

Introduction & Backgrounds: Cryptorchidism refers to the condition in which the testis has not descended to its proper place at the base of the scrotum. The most important goal for diagnosis and management of un-descended testis is to place the test is in the scrotum to maximize its potential for spermatogenesis. Here, we review the concept of cryptorchidism, its diagnosis, and complications. Then we present the results of our pro-specie study to assess the value of zoography in diagnosis of undescended testis. Patients & Methods: This prospective study was performed over 124 cases of cryptorchidism from 2002 to 2004. Statistical analysis was then performed in the value of sonographic findings in diagnosis. Results: In our survey the sensitivity of SONOGRAPHY in detecting cryptorchidism was estimated 91%. The most common site for undecided testis was inguinal canal with right side more common than the left. Results were compatible with other studies. Conclusion: SONOGRAPHY is the safest noninvasive and valuable method for detection of undescended testes. This method had 91% sensitivity in our study compatible with 97% sensitivity in other studies.