Diagnostic Ultrasonography

Diagnostic Ultrasonography

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    A pelvic ultrasound is a safe, painless procedure that uses sound waves to create images of the pelvic area that are projected onto a computer monitor. During the procedure, an ultrasound technician applies a special gel either directly to the skin of the stomach (to view the pelvic area through the abdomen) or to a probe called a transducer that is then gently inserted into the vagina (for a vaginal ultrasound in women) or the rectum (for a rectal ultrasound in men). High-frequency sound waves are transmitted from the transducer through the gel to the structures in the pelvic area and then bounce back to a computer that uses those sound waves to create an image on the screen.

    Pelvic ultrasounds can be used to examine and diagnose problems of:
    • the uterus, cervix, ovaries, fallopian tubes and vagina in women
    • the seminal vesicles and prostate gland in men
    • the bladder and kidneys in both men and women
    Pelvic ultrasound is also very helpful for minimally invasive procedures like needle biopsies, as a real-time guide for the technician. In children, a pelvic ultrasound can help determine the shape, size and position of organs in the pelvis, and can detect tumors, cysts or extra fluid in the pelvis, and help find the cause of symptoms such as pelvic pain, urinary problems or, in girls, abnormal menstrual bleeding.
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    A testicular ultrasound is a safe, painless procedure that uses sound waves to create images projected onto a computer monitor of a man's scrotum and testicles and nearby structures. During the procedure, an ultrasound technician applies a clear gel to the scrotal sac, then moves a small, hand-held device called a transducer gently over the gelled area. High-frequency sound waves are transmitted from the transducer through the gel to the structures in the scrotal area and then bounce back to a computer that uses those sound waves to create an image on the screen.

    A testicular ultrasound (or scrotal ultrasound) may be used to help diagnose the cause of several different symptoms including:
    • enlargement of the testicles
    • lumps or masses in one or both testicles
    • testicular pain
    • infertility
    • undescended testicles
    • impact of trauma to the area
    In most cases, a radiologist will interpret the results of a testicular ultrasound and confer with your primary care doctor to determine whether you need treatment, further testing, or follow-up care..
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    Venous ultrasound is the gold standard for the diagnosis of deep venous thrombosis (DVT), which is a life-threatening condition but which can be treated when diagnosed. Venous ultrasound also is available to help determine the cause of varicose veins. Positioning patients and using blood pressure cuffs can help show whether venous reflux is present. Knowing the status of venous reflux assists the physician in determining appropriate treatment options.
    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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    A vascular study -- a noninvasive (the skin is not pierced) procedure used to assess the blood flow in arteries and veins -- may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

    Generally, a vascular study follows this process:
    • You will be asked to remove any jewelry or other objects that may interfere with the procedure. You may wear your glasses, dentures, or hearing aid if you use any of these.
    • If you are asked to remove clothing, you will be given a gown to wear.
    • You will lie on an exam table or bed.
    • A clear gel will be placed on the skin at locations where the pulse is expected to be heard.
    • The Doppler transducer will be pressed against the skin and moved around over the area of the artery or vein being studied.
    • When blood flow is detected, you will hear a "whoosh, whoosh" sound. The probe will be moved around to compare blood flow in different areas of the artery or vein.
    • For arterial studies of the legs, blood pressure cuffs will be applied in three positions on the leg in order to compare the blood pressure between different areas of the leg. The cuff around the thigh will be inflated first, and the blood pressure will be determined with the Doppler transducer placed just below the cuff.
    • The cuff around the calf will be inflated, and the blood pressure will be determined as with the thigh cuff.
    • The cuff around the ankle will be inflated, and the blood pressure will be determined.
    • The blood pressure will be taken in the arm on the same side as the leg that was just studied and used to determine the degree of any occlusion of arterial flow in the legs.
    • Once the procedure has been completed, the gel will be removed from the skin.
    The technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort.
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    If you have heart disease, your physician may want to assess the health of the inside of your coronary arteries, which supply blood to your heart. To gather highly detailed images of the artery wall, your physician may use a diagnostic test called intravascular ultrasound (IVUS).

    You might already be familiar with ultrasound tests. (Pregnant women receive them, for example, to assess the health and progress of a growing baby.) Ultrasound is a procedure that transmits high-frequency sound waves through body tissues. These sound waves create echoes that are turned into video or photographic images of the organs and internal structures in the body. Ultrasounds can be used to diagnosis a variety of diseases and conditions.

    In IVUS, the ultrasound wand that transmits and receives sound waves is inside the body. A physician called an interventional cardiologist threads a thin, flexible tube called a catheter through an artery. This catheter emits sound waves from the tip and then receives the echoes. The echoes show detailed images of a section of the artery wall, including problems such as build-up of a fatty substance called plaque that clogs the arteries or an aneurysm (a bulge in the artery wall caused by a weak spot). IVUS is also used to help interventional cardiologists reopen blocked arteries and place tiny mesh-like metal tubes called stents that prop an artery open. Then IVUS can be used to assess the success of the stent placement. IVUS also provides detailed images of calcium deposits in the wall of the heart arteries. Interventional cardiologists use these images to guide a drilling device called a rotablator, which is used to clear a blockage before placing a stent.

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    Certain factors or conditions may interfere with a vascular study -- a noninvasive (the skin is not pierced) procedure used to assess the blood flow in arteries and veins. These factors include, but are not limited to, the following:
    • smoking for at least an hour before the test, as smoking causes blood vessels to constrict
    • severe obesity
    • cardiac dysrhythmias/arrhythmias (irregular heart rhythms)
    • cardiac disease
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    Vascular studies are a noninvasive (the skin is not pierced) procedure used to assess the blood flow in arteries and veins. Reasons for which vascular studies may be performed include, but are not limited to, the following:
    • evaluation of signs and symptoms which may suggest decreased blood flow in the arteries and/or veins of the neck, legs, or arms
    • evaluation of previous procedures that were performed to restore blood flow to an area
    • evaluation of a vascular dialysis device, such as an A-V fistula in the arm
    There may be other reasons for your physician to recommend a vascular study.
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    What Is a Vascular Study?
    A vascular study is used to determine whether or not a vascular disease needs to be treated. In this video, Thomas Beadle, MD from Methodist Specialty and Transplant Hospital, explains the different tests that are performed during a vascular study.
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    Vascular ultrasound is the general term for a non-invasive, painless test that uses sound waves to create images of blood vessels including arteries and veins. Ultrasound can also measure the flow of blood in these vessels.

    Ultrasound can be performed in many locations in the body. For example, the doctor may recommend a lower extremity venous ultrasound if he/she suspects a blood clot in the leg veins. Or, they may recommend a lower extremity arterial ultrasound of he/she suspects peripheral arterial disease. Ultrasound cannot be performed to image blood vessels in the chest because the sound waves do not travel well through the air in the lungs and the waves also do not travel well through the bones of the skull.

    Other common types of vascular ultrasounds are carotid ultrasounds, non-invasive flow studies and abdominal aorta ultrasounds.

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    In a breast ultrasound, high frequency sound waves exposed to breast area produce pictures of the inside of the breast, similar to an X-ray. This allows your radiologist to distinguish between a solid mass (benign or malignant tumors) and a liquid mass (cyst).

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