At First (ArtiFactual Book 5)
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English Choose a language for shopping. Both signals, from the lumen of the bowel, and from the mirrored structure, reached the transducer at a similar time, creating the visual appearance of a fetus inside the bowel.
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As the reflected signals from the mirrored fetus were distorted, the image always appeared blurred. A second contributor was a thin posterior uterine wall. A posteriorly located placenta may increase the thickness of the posterior uterine wall, thus reducing the acoustic interface between the uterus and the bowel.
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In abdominal ultrasound, mirrored and blurred artifacts are frequently observed when the gastric tube is filled with gas [ 15 ]. In Doppler sonography, mirror artifacts have been reported in 2. This has been attributed to the fact that the wall and the lumen of the vessel can create a strong acoustic interphase [ 16 , 17 ]. Despite the fact that mirror images can occur in different parts of the body, thus far only two cases have been reported in obstetrics. A subsequent transvaginal ultrasound demonstrated that there was only a single intrauterine fetus with no evidence of the two extrauterine gestational sacs.
In view of the US findings and the lack of clinical symptoms, the initial observations were considered artifacts.
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Transvaginal ultrasound showed an intrauterine sac with a normal fetus, and a second gestational sac with another active fetus was observed located in the recto-uterine pouch. The authors made the diagnosis of an abdominal heterotopic pregnancy. Due to the lack of clinical symptoms, they performed a transabdominal ultrasound scan with a full bladder.
The second gestational sac was no longer observed, and the rectouterine pouch was visualized as free and normal. Creation of an ultrasound image relies on some basic physical assumptions, such as: Only a small fraction of the ultrasound waves are reflected and the majority are either refracted or transmitted [ 20 ]. When these assumptions are violated, multiple echo pathways, and velocity and attenuation errors can generate imaging artifacts such as: If ultrasound artifacts are not promptly recognized, they may lead to errors such as: In our case, the ultrasound image raised the suspicion of a second fetus located immediately posterior to the uterus, although it was never possible to obtain a clear image of such a fetus.
Also, the clinical symptoms of the patient did not match the ultrasound findings. The presence of synchronic and opposite fetal movements oriented to the identification of a mirror artifact. Magnetic resonance imaging performed one day later excluded any possibility of an abdominal heterotopic pregnancy.
The patient underwent an uncomplicated pregnancy and delivered a normal, full-term, and healthy neonate. During obstetric ultrasound, image artifacts can be produced. A proper recognition of these artifacts can reduce the risk of misdiagnosis. National Center for Biotechnology Information , U.
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Author manuscript; available in PMC Sep Author information Copyright and License information Disclaimer. Roberto Romero, MD, D. The publisher's final edited version of this article is available at Fetal Diagn Ther. See other articles in PMC that cite the published article.
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Associated Data Supplementary Materials Video 1. Abstract Mirror artifacts are produced by the reflection of ultrasound waves after they propagate through a structure and encounter a strong and smooth interface capable of acting as a mirror.
Princeton University Press, Recently, specialized headband type or headset type devices, which are endowed with small number of electrodes less than gold standard devices having 16, 32, 64, or more channels, have been developed as for compact, portable, and feasible EEG systems to use themselves in the real environments [ 7 ]. University of New Mexico Press, pp. Show Hide Page Numbers. Better Homes and Gardens: Withoutabox Submit to Film Festivals. New Literary History , 2 2 ,
Ultrasound artifacts, ultrasound physics, pregnancy, ultrasound reflection, twin gestation, abdominal heterotopic pregnancy, diagnostic error. Introduction Despite substantial advances in ultrasound imaging, diagnostic challenges continue to occur.
Open in a separate window. Discussion In the ultrasound artifact presented here, a maternal recto-sigmoid containing a gas-fluid interface located immediately posterior to a thin uterine wall acted as a mirror. Conclusion During obstetric ultrasound, image artifacts can be produced. A mirror artifact creating an extra fetus has not been previously reported at this advanced gestational age 18 weeks of gestation. This is the first report of a mirror artifact in obstetrics documented using both transabdominal and transvaginal ultrasound.
This is the first report of synchronous but opposite movements between the real fetus and the mirrored image. Supplementary Material Video 1 Video 1 Transabdominal ultrasound showing the real fetus in the anterior part of the image, the reflective surface posterior wall of the uterus, and bowel wall and the mirrored image in the back of the image. Click here to view.
Video 2 Video 2 Transabdominal ultrasound showing the real fetus in the anterior part of the image, the reflective surface posterior wall of the uterus, and bowel wall and the mirrored image in the back of the image. Video 3 Video 3 Transvaginal ultrasound with the reflected mirrored image visible in the right side of the screen.
In ethnography and archaeology, a category of "ancestral artifact" has been proposed, defined as "any object of natural raw material chert, obsidian, wood, bone, native copper, and so on made by a people following a lifestyle based on foraging e. From Wikipedia, the free encyclopedia. Retrieved 2 August — via CollinsDictionary. A Test Case from Eastern England". Journal of Field Archaeology.
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