ULTRASONOGRAPHY
ULTRASONOGRAPHY
ULTRASONOGRAPHY
OVERVIEW
Transmits high-frequency sound waves through the eye and measures their reflection from
ocular structure.
A-scan converts echoes into waveforms whose crests represent the positions of different
structures, providing a one-dimensional picture.
A-scan is more valuable in measuring eye’s axial length and characterizing tissue texture of
abnormal lesions.
Helpful in evaluating a fundus clouded by an opaque medium such as cataract.
Purpose
PROCEDURE
Preparation
Implementation
After the test, remove the water-soluble gel from the patient’s eyelid.
INTERPTRETATION
Normal Results
The optic nerve and the posterior lens capsule produce echoes that take on characteristic forms
on A and B-scan images.
The posterior wall of the eye appears as a smooth, concave curve.
The lens and vitreous humor are also visible.
Normal orbital echo patterns depend on the position of the transducer and the position of the
patient’s gaze during the procedure.
Abnormal Results
ULTRASONOGRAPHY, LIVER
OVERVIEW:
Transmits high-frequency sound waves into the right upper quadrant of the abdomen; the
resultant echoes are converted to electrical energy, amplified by a transducer and displayed on
a monitor.
Depicts various tissue densities by different shades of gray.
Shows intrahepatic structures as well as organ size, shape and position.
PURPOSE:
PROCEDURE:
Preparation:
Implementation:
Patient care:
Remove lubricating jelly from the patient’s care.
Have the patient resume his usual diet.
Complications:
None known
INTERPRETATION:
Normal Results
The liver demonstrates a homogenous, low-level echo pattern, interrupted only by the different
echo patterns of its vascular channels.
Intrahepatic biliary radicles and hepatic arteries aren’t apparent, but portal and hepatic veins,
the aorta and the inferior vena cava appear.
Hepatic veins appear completely sonolucent; portal veins have margins that are highly
echonegic.
Abnormal Results
Dilated intrahepatic biliary radicles and extrahepatic ducts suggest obstructive jaundice.
Variable liver size, dilated, tortuous portal branches associated with portal hypertension and an
irregular echo pattern with increased echo amplitude, suggest possible cirrhosis.
Hepatomegaly and a regular echo pattern that although greater in echo amplitude than that of
normal parenchyma, don’t alter attention suggest possible fatty infiltration of the liver.
Interfering Factors
OVERVIEW
Transmits high-frequency sound waves into the epigastric region; resultant echoes are
converted to electrical impulses, amplified by transducer and displayed on a monitor.
The display pattern varies with the tissue density and represents the size, shape, and
position of the pancreas and surrounding viscera.
Can’t provide sensitive measure of pancreatic function but is useful in detecting anatomic
abnormalities, such as pancreatic carcinoma and pseudocytes and in guiding the insertion of
biopsy needles.
Purpose
PROCEDURE
Preparation:
Implementation:
Patient Care
INTERPRETATION
Normal Results
The pancreas demonstrates a coarse, uniform echo pattern (reflecting tissue density) and is
usually more echogenic than the adjacent liver.
Abnormal Results
Alterations in the size, contour and parenchyma texture of the pancreas suggest possible
pancreatic disease.
An enlarged pancreas with decreased echogenicity and distinct borders suggests pancreatitis.
A well-defined mass with an essentially echo-free interior suggest pseudocyts.
INTERFERING FACTORS
OVERVIEW
Transmits high-frequency sound waves into the interior pelvic region; resultant echoes are
converted to electrical impulses, amplified by a transducer and displayed on a monitor.
A-mode technique records only distances between interfaces.
Used to evaluate symptoms that suggests pelvic disease, to confirm a tentative diagnosis and to
determine fetal growth during pregnancy.
Purpose:
To detect foreign bodies and distinguish between cyst and solid masses.
To measure organ size
To evaluate fetal viability, position, gestational age and growth rate.
To detect multiple pregnancy.
To confirm fetal and maternal abnormalities
PROCEDURE
Preparation:
Implementation
With the patient in supine position, coat the lower abdomen with mineral oil or water-soluble
jelly to increase sound wave conduction.
The transducer crystal is guided over the area, images are observed on the oscilloscope screen
and good images are photographed.
Patient Care
Allow the patient to empty her bladder immediately after the test.
Remove ultrasound gel from the patient’s skin.
INTERPRETATION
Normal Results
Abnormal Results
Homogenous densities suggests both cysts and solid masses; however, solid masses appear
more dense on ultrasonography.
Inappropriate fetal size suggest possible miscalculation of conception or delivery date.
Fetal abnormalities suggest possible malpresentation and cehalopelvic disproportion.
ULTRASONOGRAPHY, SPLEEN
OVERVIEW
Transmits high frequency sound waves into the left upper quadrant of the abdomen, creating
echoes that vary with changes in tissue density.
Echoes converted to electrical energy, amplified by transducer and displayed on a monitor.
Indicated for patients with a left upper quadrant mass of unknown origin, with known
splenomegaly.
Can show splenomegaly, but usually doesn’t identify the cause.
Purpose:
To demonstrate splenomegaly.
To monitor progression of primary and secondary splenic disease.
To evaluate the effectiveness of therapy.
To evaluate the spleen after abdominal trauma.
To detect splenic cysts and subphrenic abscess.
PROCEDURE
Preparation
Implementation
Because the procedure for ultrasonography varies depending on the size of the spleen or the
patient’s body habitus, it’s usually necessary to reposition the patient several times.
A water-soluble lubricant is applied to the face of the transducer and the transverse scans of the
spleen are taken ½” to 1”(1-2.5 cm) intervals, beginning at the level of the diaphragm and
moving posteriorly while the transducer is angled anteromedially.
After the patient is placed in right lateral decubitus position, additional transverse scans are
taken through the intercostals spaces using a sectoring motion.
For longitudinal scans, the patient remains in the right lateral decubitus position and scans are
taken from the axilla toward the iliac crest.
To prevent the artifacts, oblique scans are taken by passing the transducer face along the
intercostals spaces, this scan provides the best view of the splenic parenchyma.
During each scan, the patient may be asked to hold his breath briefly at varying stages of
inspiration.
Patient Care
INTERPRETATION
Normal Results
Abnormal Results
Increased echogenicity and enlarged vascular channels, especially in the hilar region, suggest
splenomegaly.
Splenomegaly and an irregular, sonolucent area suggest splenic rupture.
A sonolucent area beneath the diaphragm suggests possible subphrenic abscess.
ULTRANOSONGRAPHY, THYROID
OVERVIEW
Emits pulses from a piezoelectric crystal in a transducer, directed at the thyroid gland and
reflected back to the transducer.
Can also be performed on parathyroid glands.
Useful in evaluating thyroid nodules during pregnancy because it doesn’t expose the fetus to
radioactive iodine used in other diagnostic procedures.
Purpose:
PROCEDURE
Preparation
Implementation
Assist the patient into a supine position with a pillow under his shoulder blades to hyperextend
his neck.
Coat the patient’s neck with water-soluble gel.
The transducer scans the thyroid, projecting its echo graphic image on the oscilloscope screen.
The image on the screen is photographed for subsequent examination.
Patient Care
INTERPRETATION
Normal Results
Abnormal Results
Smooth-bordered, echo-free areas with enhanced sound transmission suggest cyst.
Solid and well-demarcated areas with identical echo patterns suggest adenomas and
carcinomas.
TRANSVAGINAL ULTRASONOGRAPHY
OVERVIEW
Imaging technique using high-frequency sound waves to produce images of the pelvic
structures.
Allows evaluation of pelvic anatomy and diagnosis of pregnancy at an earlier gestational
age.
Eliminates the need for a full bladder and circumvents difficulties encountered with obese
patients
Also known as endovaginal ultrasound.
Purpose
To establish early pregnancy with fetal heart motion as early as the 5 th-6th week of gestation
To identify ectopic pregnancy.
To monitor follicular growth during infertility treatment.
To evaluate abnormal pregnancy
To visualize retained products of conception.
To diagnose fetal abnormalities, placental location and cervical length
To evaluate uterine lining.
PROCEDURE
Preparation
Implementation
Patient Care
Help the patient remove any residual gel.
INTERPRETATION
Normal results
Abnormal Results