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ultrasound (US, UTZ)

The use of high frequency sound waves (1.6-10 MHz) in medical imaging. Deep structures may be delineated by measuring the reflection or transmission of ultrasonic waves. The ultrasound image displays in a single plane at a time; however, computer calculations allow for 2 dimensional real-time imaging. Real-time imaging displays motion, doppler displays flow. 1971 pulsed doppler (M-mode - movement) 1974 B mode (brightness) 'Duplex scanner' M & B modes - Advantages of ultrasound: 1) biologically harmless 2) can display motion 3) requires no contrast 4) provides images in many planes 5) available at the bedside 6) able to differentiate solid tissue from fluid 7) low cost - Disadvantages of ultrasound: 1) bone cannot be penetrated 2) gas-containing structures (e.g. bowel) are obstacles 3) operator-dependent - angle of incination should be 60 degrees - Clinical uses of ultrasound: 1) echocardiography 2) location of foreign bodies in the eye 3) pregnancy a) suspected ectopic pregnancy b) suspected fetal demise c) estimate of gestational age d) confirm presence of multiple fetuses e) localization & evaluation of placenta f) estimate of amount of amniotic fluid - normal, oligohydramnios, polyhydramnios g) detectection of fetal anomalies h) repeated ultrasound does not pose risk to fetus [2] 4) postpartum retained products of conception 5) newborn a) head - intracranial hemorrhage, hydrocephalus b) kidneys - renal dysplasia, lower urinary tract obstruction c) liver - biliary atresia, hepatitis 6) spleen a) splenomegaly b) subcapsular hematoma c) the spleen is the most commonly injured organ in blunt abdominal trauma 7) pancreas - tumor versus cyst or pseudocyst 8) liver - solid or cystic lesions, abscesses 9) kidneys a) hydronephrosis; b) renal cysts; c) renal tumors; d) polycystic kidney disease 10) abdominal abscesses 11) gallstones - 90% of gallstones are radiolucent 12) dilation of the biliary tree as in obstructive jaundice 13) abdominal aortic aneurysms 14) thyroid - cystic versus solid thyroid nodules 15) parathyroid adenoma 16) testes - tumor versus hydrocele or hematocele 17) musculoskeletal ultrasonography [3] - synovitis, tendonitis, bursitis, joint effusion

Specific

abdominal ultrasound bladder scan breast ultrasound; somo-v Automated Breast Ultrasound System (ABUS) carotid intimal medial thickness (CIMT) carotid ultrasound central cardiovascular study by US doppler effect/shift/principle/phenomenon doppler sonography/ultrasonography (DUS) duplex doppler scan echocardiography echocardiography bubble study; saline contrast study elastography endoscopic ultrasound; endosonography (EUS) fetal ultrasound Focused Assessment with Sonography for Trauma (FAST); Focused Multiorgan Bedside Ultrasound focused ultrasound gastrointestinal ultrasound hepatobiliary ultrasonography ICU-sound protocol inferior vena cava collapsibility index intravascular ultrasound laparoscopic ultrasound low intensity pulsed ultrasound (LIPUS) MRI-guided transcranial focused ultrasound (ExAblate Neuro) pelvic ultrasound point of care ultrasonography renal ultrasound retroperitoneal ultrasound therapeutic ultrasound transbronchial ultrasound transcranial sonography (TCS) transrectal ultrasound of prostate transvaginal ultrasonography (TVS) ultrasound anus ultrasound aortic arch & neck ultrasound aortic root ultrasound aortic valve ultrasound appendix ultrasound artery ultrasound AV fistula ultrasound axilla ultrasound biliary ducts & gallbladder ultrasound brachial plexus ultrasound breast specimen ultrasound chest ultrasound chest wall ultrasound diaphragm ultrasound diaphragm & liver ultrasound endometrium ultrasound extremity ultrasound extremity nonvascular ultrasound eye + orbit ultrasound femoral & popliteal veins ultrasound femoral vesselss ultrasound follicle ultrasound gallbladder ultrasound of chest/mediastinum ultrasound of scrotum ultrasound soft tissue head & neck ultrasound wound therapy ultrasound, infant hips ultrasound, spinal canal ultrasound, transplanted kidney

General

radiography (roentgenography)

References

  1. Introduction to Clinical Imaging, Radiology Syllabus, UCSF, 1993
  2. Journal Watch 25(2):16-17, 2005 Newnham JP, Doherty DA, Kendall GE, Zubrick SR, Landau LL, Stanley FJ. Effects of repeated prenatal ultrasound examinations on childhood outcome up to 8 years of age: follow-up of a randomised controlled trial. Lancet. 2004 Dec 4;364(9450):2038-44. PMID: 15582061
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  4. Joshua F Ultrasound applications for the practicing rheumatologist. Best Pract Res Clin Rheumatol. 2012 Dec;26(6):853-67 PMID: 23273796

Images

images related to ultrasound