General Ultrasound
Doppler ultrasound of the kidney
showing blood vessels like the
branches of a tree. |
Ultrasound (US) imaging, also called ultrasound scanning or
sonography, is a method of obtaining images from inside the human
body through the use of high frequency sound waves. The reflected
soundwave echoes are recorded and displayed as a real-time visual
image. No ionizing radiation (x-ray) is involved in ultrasound
imaging. Obstetric ultrasound refers to the specialized use of
sound waves to visualize and thus determine the condition of
a pregnant woman and her embryo or fetus.
Ultrasound is a useful way of examining many of the body's internal
organs, including the heart, liver, gallbladder, spleen, pancreas,
kidneys, and bladder. Because ultrasound images are captured
in real-time, they can show movement of internal tissues and
organs, and enable physicians to see blood flow and heart valve
functions. This can help to diagnose a variety of heart conditions
and to assess damage after a heart attack or other illness.
What are some common uses of the procedure?
Millions of expectant parents have seen the first "picture" of
their unborn child with pelvic ultrasound examinations of the
uterus and fetus. Ultrasound imaging is used extensively for
evaluating the eyes, pelvic and abdominal organs, heart, and
blood vessels, and can help a physician determine the source
of pain, swelling, or infection in many parts of the body. Because
ultrasound provides real-time images, it can also be used to
guide procedures such as needle biopsies, in which a needle is
used to sample cells from an organ for laboratory testing. Ultrasound
is now being used to image the breasts and to guide biopsy of
breast cancer (see the Ultrasound-Guided Breast Biopsy page).
Ultrasound is also used to evaluate superficial structures such
as the thyroid gland and scrotum (testicles).
Doppler ultrasound is a special technique used to examine blood
flow. Doppler images can help the physician to see and evaluate:
- blockages to blood flow (such as clots)
- build-up of plaque inside the vessel
- congenital malformation
How should I prepare for the procedure?
You should wear comfortable, loose-fitting clothing for your
ultrasound exam. Other preparation depends on the type of examination
you will have. For some scans, your doctor may instruct you
not to eat or drink for as many as 12 hours before your appointment.
For others, you may be asked to drink up to six glasses of
water two hours prior to your exam and avoid urinating, so
that your bladder is full when the scan begins.
What does the equipment look like?
Ultrasound scanners consist of a console containing a computer
and electronics, a video display screen and a transducer that
is used to scan the body. The transducer is a small hand-held
device about the size of a bar of soap, attached to the scanner
by a cord. The physician or technologist spreads a lubricating
gel on the patient's abdomen in the area being examined, and
then presses the transducer firmly against the skin to obtain
images.
The ultrasound image is immediately visible on a nearby screen
that looks much like a computer or television monitor. The physician
or technologist watches this screen during an examination and
captures representative images for storage. Often, the patient
is able to see it as well.
How does the procedure work?
Ultrasound imaging is based on the same principles involved
in the sonar used by bats, ships at sea, and anglers with fish
detectors. As the sound passes through the body, echoes are
produced that can be used to identify how far away an object
is, how large it is, its shape, and its consistency (fluid,
solid or mixed).
The ultrasound transducer functions as both a generator of sound
(like a speaker) and a detector (like a microphone). When the
transducer is pressed against the skin, it directs inaudible,
high-frequency sound waves into the body. As the sound echoes
from the body’s fluids and tissues, the transducer records
the strength and character of the reflected waves—with
Doppler ultrasound the microphone captures and records tiny changes
in the sound wave's pitch and direction of the sound. These echoes
are instantly measured and displayed by a computer, which in
turn creates a real-time picture on the monitor. The live images
of the examination are usually recorded on videotape, but one
or more frames of the moving picture may be "frozen" to
capture a still image.
How is the procedure performed?
The patient is usually positioned on an examination table.
A clear gel is applied to the patient's body in the area to be
examined, to help the transducer make secure contact with the
skin. The sound waves produced by the transducer cannot penetrate
air, so the gel helps eliminate air pockets between the transducer
and the skin. The technologist or radiologist presses the transducer
firmly against the skin and sweeps it back and forth to image
the area of interest.
When the examination is complete, the patient may be asked to
dress and wait while the ultrasound images are reviewed, either
on film or on a TV monitor. Often, though, the technologist or
radiologist is able to review the ultrasound images in real-time
as they are acquired, and the patient can be released immediately.
What will I experience during the procedure?
Most ultrasound examinations are painless, fast, and easy.
You will lie on your back on an examining table. The technologist
or doctor will spread some warm gel on your skin and then press
the transducer firmly against your body, moving it until the
desired images are captured. There may be varying degrees of
discomfort from pressure as the technologist guides the transducer
over your abdomen, especially if you are required to have a
full bladder. The examination usually takes less than 30 minutes.
Who interprets the results
and how do I get them?
A radiologist, who is a physician experienced in ultrasound
and other radiology examinations, will analyze the images and
send a signed report with his or her interpretation to the patient’s
personal physician. The patient receives ultrasound results
from the referring physician who ordered the test results.
In some cases the radiologist may discuss preliminary results
with you at the conclusion of your examination. New technology
also allows for distribution of diagnostic reports and referral
images over the Internet at many facilities.
What are the benefits vs. risks?
Benefits
- Ultrasound scanning is noninvasive (no needles or injections,
in most cases) and is usually painless.
- Ultrasound is widely available and easy to use.
- Ultrasound uses no ionizing radiation, and is the preferred
image modality for diagnosis and monitoring of pregnant women
and their unborn infants.
- Ultrasound provides real-time imaging, making it a good tool
for guiding minimally invasive procedures such as needle biopsies.
- Ultrasound images can visualize structure, movement and live
function in the body's organs and blood vessels.
Risks
- For standard diagnostic ultrasound there are no known harmful
effects on humans.
What are the limitations of General Ultrasound Imaging?
ltrasound has difficulty penetrating bone and therefore can only
see the outer surface of bony structures and not what lies within.
For visualizing bone or internal structure of certain joints, waves
do not reflect clearly from bone or air. For visualization of bone,
other imaging modalities, such as magnetic resonance imaging (MRI),
may be selected.