Professional Documents
Culture Documents
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Strengths of Ultrasonography
Determining origin of an abdominal mass Evaluation of organ parenchyma
Liver, spleen, kidneys, adrenals, pancreas, intestines, prostate, bladder, heart
Fetal viability Real time scanning see movement/motion Performing fine needle aspiration/ biopsy
Cells or tissue NOT images ultimately give us the definitive diagnosis for neoplasia, etc. Ultrasound does not provide a histopathologic diagnosis www.upei.ca/~vetrad
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Weaknesses of Ultrasonography
Ultrasound cant penetrate gas or bone Difficult to evaluate liver size, kidney size in dogs Cant assess intestinal gas patterns Cant evaluate some extra abdominal structures (i.e. spine) Equipment can be expensive Diagnostic success is user dependent Must know anatomy very well
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Acoustic Impedance
The velocity of sound in a tissue and tissue density = determine acoustic impedance Most soft tissues = 1400-1600m/sec Bone = 4080, Air = 330
Sound will not penetrate gets reflected or absorbed
Attenuation
Absorption = energy is captured by the tissue then converted to heat Reflection = occurs at interfaces between tissues of different acoustic properties Scattering = beam hits irregular interface beam gets scattered
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Frequency Penetration
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Transducers
Sector scanner fan shaped beam
Small surface require for contact
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Freeze Depth
Zoom in superficial, or zoom out for wide view Depth limited by frequency
Focal zone
Optimal resolution wherever focal zone is
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Image controls
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Modes of Display
A mode
Spikes where precise length and depth measurements are needed ophtho
Artifacts
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Reverb
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Partial Mirror
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Enhancement
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Enhancement
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Enhancement
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Refraction
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Ultrasound Terminology
Never use dense, opaque, lucent Anechoic
No returning echoes= black (acellular fluid)
Echogenic
Regarding fluid--some shade of grey d/t returning echoes
Relative terms
Comparison to normal echogenicity of the same organ or other structure Hypoechoic, isoechoic, hyperechoic
Spleen should be hyperechoic to liver
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Sepsis
Abscesses
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I Occasionally aspirate
Kidneys (esp. if enlarged) Pancreas Urinary bladder masses
I Never aspirate
Adrenals Gall bladder
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Ultrasound-guided FNA
Aspiration technique
Same set up as with non-aspiration technique With needle in structure, pull back plunger vigorously several times Remove needle, fill syringe with air Spray onto slide and smear
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Biopsy Bleeding???
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Catheter in Bladder
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Intro Summary
Know your limitations
Lack of expertise $15,000 vs. $150,000 machine
For abd or thx, do radiographs first If safe and reasonable, do FNAs of all suspected abnormal structures based on history, clinical signs, or the ultrasound exam
Abnormal structures can look normal Of the structures that do look abnormal, benign and malignant processes can be identical
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