An ultrasound procedure is a non-invasive (the skin is not pierced) diagnostic procedure used to assess soft tissue

structures such as muscles, blood vessels, and organs.

Ultrasound uses a transducer that sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the organs and structures within. The sound waves bounce off the organs like an echo and return to the transducer. The transducer picks up the reflected waves, which are then converted by a computer into an electronic picture of the organs or tissues under

1. Image Mood 2. Doppler Mood

A-mode Now obsolete in medical imaging. Wave spikes are represented when a single beam passes through objects of different consistency and hardness. The distance between these spikes (for example A and B) can be measured accurately by dividing the speed of sound in tissue (1540 m/sec) by half the sound travel time.

B-mode ("Brightness") Same as A-mode, but one-dimensional graphical display, with brightness corresponding to amplitude of reflected sound

M-mode A single beam in an ultrasound scan can be used to produce an M-mode picture, where movement of a structure such as a heart valve can be depicted in a wave-like manner. Because of its high sampling frequency (up to 1000 pulses per second), this is useful in assessing rates and motion and is still used extensively in cardiac and fetal cardiac imaging.

2D-real time Most modern ultrasound devices are 2D-real time imaging systems. Multiple crystals (linear, curved or phasedarray) or moving crystal. Sequential B-mode pulses sweeping across a plane to display the image in either a linear or µsector¶ format. Displayed as real time imaging with up to 100 images per

Pulsed-wave Doppler (PW) Apparent change in received frequency due to relative motion between a sound source and sound receiver.

Continuous-wave Doppler (CW) ‡ Uses different crystals to send and receive the signal ‡ One crystal constantly sends a sound wave of a single frequency, the other constantly receives the reflected signal ‡ No depth precision ‡ Does not alias

Colour Doppler ‡ Utilises pulsed-echo Doppler flow principles to generate a colour image.

Power Doppler (CPD) The colour maps for Power are represented by a single continuous colour Power does not provide DIRECTIONAL information, so no aliasing CPA provides better sensitivity to slow flow states Less angle dependent than traditional colour But more sensitive to motion artifact

Directional Power Doppler Combines power (amplitude) of Doppler signal with directional (phase) information

Duplex Systems or scans which combine imaging and Doppler with image guidance are often referred to as duplex systems or duplex scans.

‡ Doppler ultrasound - used to see structures inside the body, while evaluating blood flow at the same time. Doppler ultrasound can determine if there are any problems within the veins and arteries. ‡ Vascular ultrasound - used to see the vascular system and its function, including detection of blood clots.

‡ Echocardiogram - used to see the heart and its valves, and to evaluate the effectiveness of the heart's pumping ability. ‡ Abdominal ultrasound - used to detect any abnormalities of the abdominal organs (i.e., kidneys, liver, pancreas, gallbladder), such as gallstones or tumors.

‡ Renal ultrasound - used to examine the kidneys and urinary tract. ‡ Obstetrical ultrasound - used to monitor the development of the fetus.

‡ Pelvic ultrasound - used to find the cause of pelvic pain, such as an ectopic pregnancy in women, or to detect tumors or masses.

‡ Breast ultrasound - used to examine a mass in the breast tissue. ‡ Thyroid ultrasound - used to see the thyroid and to detect any abnormalities.

‡ Scrotal ultrasound - used to further investigate pain in the testicles. ‡ Prostate ultrasound - used to examine any nodules felt during a physical

‡ Musculoskeletal ultrasound - used to examine any joint or muscle pain for conditions, such as a tear.

‡ Interventional ultrasound - used to help the surgeon during a minimally invasive operation or biopsy. ‡ Intravascular ultrasound (IVUS) used to provide direct visualization and measurement of the inside of blood vessels.

‡ Endoscopic ultrasound - used to obtain direct ultrasound examination of the inside of a body cavity or organ, using an ultrasound transducer inside an endoscope (a small, flexible tube with a light and a lens on the end).

Ultrasound is used to help physicians evaluate symptoms such as: ‡ pain ‡ swelling ‡ infection

Ultrasound is a useful way of examining many of the body's internal organs, including but not limited to the: ‡ heart and blood vessels, including the abdominal aorta and its major branches ‡ liver ‡ gallbladder

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spleen pancreas kidneys bladder uterus, ovaries, and unborn child (fetus) in pregnant patients ‡ eyes ‡ thyroid and parathyroid glands ‡ scrotum (testicles)

Ultrasound is also used to: ‡ guide procedures such as needle biopsies, in which needles are used to extract sample cells from an abnormal area for laboratory testing. ‡ image the breasts and to guide biopsy of breast cancer ‡ diagnose a variety of heart conditions and to assess damage after a heart attack or diagnose for valvular heart disease.

Preparations for an ultrasound test depend greatly on the type of ultrasound being performed. Most ultrasound tests require little or no preparation. For ultrasounds being performed on internal organs, such as the gallbladder, patients may be asked to avoid eating or drinking for six to eight

However, for other ultrasounds, such as pregnancy or bladder tests, the patient may be asked to drink up to six glasses of water prior to the test to fill the area with extra fluid. The excess fluid in the bladder helps to move air-filled bowel loops away from the area of concern for a clearer view. Rectal ultrasounds may require an enema to cleanse the bowel several hours beforehand.

Smoking or other use of nicotine can interfere with ultrasound testing by causing blood vessels to constrict. A patient may be advised to avoid cigarettes, chewing tobacco and other nicotine products at least two hours before the test. Additionally, swallowing air can alter the results of some ultrasound testing because ultrasound waves do not pass through air. This is the reason that ultrasound testing is not commonly used on the stomach, small intestine or large intestine.

In preparation for an ultrasound, it may be helpful to ask a health care provider about: ‡ Eating or drinking restrictions prior to the test ‡ Taking any medications or supplements prior to the test ‡ Avoiding soda or other carbonated drinks before the test ‡ Wearing loose-fitting, comfortable clothing ‡ Leaving jewelry and valuables at home

‡ You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined. ‡ You may be asked to wear a gown during the procedure. ‡ 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

Most often, ultrasounds are performed on an outpatient basis, but these tests are also used in hospitals as part of diagnostic patient care. In general, most ultrasounds follow a similar procedure:

1. Depending on the area being tested, the patient may lie on a padded examining table during the test. During the actual test, which normally takes less than 30 minutes, it may be necessary to change into a hospital gown, depending on the area to be examined.

2. A small amount of water-soluble gel, which acts as a conducer, is placed on the part of the body to be tested and/or directly on the transducer, a small device that sends ultrasound waves through the body. The gel does not harm the skin or stain clothing. The ultrasound transducer should not be placed over an open or draining wound.

3. The technician places the transducer on the part of the body to be scanned. In some tests, a probe transducer may be placed within an opening, such as the vagina or rectum. 4. The sound waves sent from the transducer bounce off the structures within the body and the information is deciphered by the computer to create the ultrasound images.

5. The ultrasound images then appear on the television monitor and the moving pictures can be recorded.

‡ There is no pain associated with the ultrasound test. Minor discomfort may be caused by the pressure of the transducer against the skin or, in the case of transrectal or transvaginal ultrasound, the insertion of the probe in a body cavity.

After the test, the gel is wiped away. The test is then evaluated by a radiologist, and results are relayed to the patient¶s primary healthcare provider. If the ultrasound shows a problem, additional diagnostic tests, such as an MRI (magnetic resonance imaging), may be recommended.

‡ In extensive studies, no risks associated with properly conducted medical diagnostic ultrasound have been documented. These ultrasounds are considered to be extremely safe, with no harmful side effects associated with this procedure. Unlike x-rays, there is no exposure to radiation during an ultrasound. This test is a noninvasive or minimally invasive procedure that is widely available, easy to use, inexpensive and causes little patient discomfort.

‡ Ultrasound therapy can pose some risks, such as burns from misuse. However, such problems are uncommon when the therapy is performed by a properly trained healthcare professional.

Thank you for listening!
³For each petal on the shamrock this brings a wish your way. Good health, good luck, and happiness for today and every day.´ ~ Irish quote

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