The processus vaginalis is a blind‐ended evagination of the abdominal wall that develops during fetal life and typically undergoes obliteration in early life. Persistence of the processus vaginalis is associated with a number of pathologies including congenital indirect inguinal hernias, communicating hydroceles, funicular and encysted hydroceles, canal of Nuck cysts, and acquired undescended testis. Whilst all are detectable sonographically, there is little educational material relevant to the field of ultrasound with much of the literature directed at surgical and primary care physicians. Furthermore, within the literature there is a lack of consensus on several areas including the anatomy and embryology of the processus vaginalis and the mechanisms behind its obliteration. As such the objective of this paper is to distil the information regarding the persistent processus vaginalis as it is relevant to ultrasound and in doing so address the literature gap for sonographers and sonologists. The anatomy and embryology of the persistent processus vaginalis will be discussed including causative mechanisms for anomalies with their sonographic appearance highlighted.

Objectives: To identify gaps in Australian sonographer's knowledge and application of as low as reasonably achievable (ALARA) principles during first trimester imaging; Identify relationships between demographic variables and knowledge or application of the Output Display Standard (ODS) value thermal index (TI) and compare Australian sonographers to their international peers. Methods: Australian Sonographer Accreditation Registered (ASAR)-registered sonographers completed a voluntary questionnaire over September 2015 after institutional ethics approval . Seventeen questions detailed their demographics (5); knowledge of ultrasound bioeffects terminology and ALARA principles (9); behaviour surrounding ALARA and first trimester imaging (2) and continuing bioeffects education (1). Exclusion criteria was non-ASAR status. Descriptive (mode frequency) and inferential statistics (Fisher exact test) were used. Significance level was 95%. Results: Ninety-five valid surveys were collected. Ninety-nine per cent knew the meaning of ALARA, 93.55% correctly defined 'TI' and 85.39% knew where to find the TI value via the ODS. Half never monitor the ODS. No correlation (P = 0.094) was found between experience and ODS monitoring. No statistical difference (P = 0.189) existed between obstetric and non-obstetric sonographers who knew the meaning of TIB (87.18% vs. 76.92%) or those who correctly identified it as the setting for 11-14-week examinations (30.77% vs. 30.77%). When using Doppler during obstetric examinations, no difference existed (P = 0.293), between obstetric and non-obstetric sonographers' knowledge of ASUM/WFUMB guidelines for maximum TI (47.37% vs. 46.15%). Conclusions: Despite poor ODS usage, Australian sonographers outperform their international peers for ALARA literacy, and show better application of ALARA principles in the first trimester. No relationships were found between demographic variables and knowledge or conscious monitoring of ODS.

Objectives: 2D ultrasound TAPSE and MAPSE examination may characterise ventricular function in the fetus. We aimed to evaluate feasibility of STIC M-mode for measuring TAPSE and MAPSE in the second half of gestation. Methods: We recruited gravidae presenting from 20 to 34 weeks for routine surveillance, with structurally normal singleton pregnancies. STIC volumes of a complete cardiac cycle were acquired and saved. Manipulation of the volumes and measurements were performed offline in post-processing and in a lower speed. All unnamed volumes were evaluated by two operators to assess repeatability. 15 STIC volumes were also duplicated and appeared randomly three times each for intraobserver repeatability evaluation. The operators scrolled through each volume to optimise the 4 chamber view then rotated the cardiac apex to 12 o'clock. The M-mode beam was aligned through the lateral aspect of the tricuspid valve annulus, parallel to the interventricular septum. The x-and y axes were further adjusted in order to define the most appropriate distinct line to measure the maximum annular movement. The excursion, or vertical movement, of the tricuspid annulus during systole and diastole was measured from the M-mode wave amplitude. This process was then repeated for mitral annulus excursion. Inter-and intraobserver variability were tested with intraclass correlation coefficients (ICC). Results: 60 volumes from 16 gravidae were evaluated by each operator. The mean TAPSE was 5.4 (SD, 1)mm and 5.3 (SD, 1.1)mm measured by operator 1 and 2 respectively. The mean MAPSE was 4.3 (SD, 0.8)mm and 4.2 (SD, 0.7)mm measured by operator 1 and 2 respectively. ICCs for TAPSE were high with intraobserver ICCs of 0.94 and 0.92 for operator 1 and 2 and an interobserver ICC of 0.91. MAPSE ICCs were lower with intraobserver ICCs of 0.80 for both operators and interobserver ICC of 0.76. Conclusions: STIC allows easy and accessible evaluation of systolic function in the fetus, that is reliable and repeatable, more so for TAPSE than MAPSE.OP02. Objectives: Z-scores for mitral -tricuspid valve distance (MTD) in normal fetuses and fetuses with Ebstein anomaly were developed from the measurements of femur length (FL), biparietal diameter (BPD) or gestational age (GA) using fetal echocardiography. Methods: A retrospective cross-sectional study of 1216 singleton normal fetuses (20 ∼ 40 weeks) and 15 fetuses (19 ∼ 36weeks) with Ebstein anomaly was performed. MTD was measured in a standard apical four-chamber view. MTD z-scores for normal fetuses and fetuses with Ebstein anomaly were compared. Results: Compared with normal fetuses, the MTD in fetuses with Ebstein anomaly was statistically increased(P < 0.01), the MTD in normal fetuses was (3.5 ± 0.6)mm with a range of 0.9 ∼ 5.5 mm, while the MTD in fetuses with Ebstein anomaly was (9.6 ± 2.5) mm with a range of 4.5 ∼ 11.4 mm. The MTD z-score in fetuses with Ebstein anomaly was statistically different (P < 0.01), the MTD z-score in 100% fetuses with Ebstein anomaly were found > +3. Conclusions: Normal ref...