Archive for ‘Ultrasound’

February 9, 2016

Centered on the Inner Athlete in YOU!

April 16, 2015

All About the Belly: Abdominal Ultrasound

uplifting buddha by faria! via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)Bellies are where we keep things, from laughter to turkey dinners to babies. But bellies hold more than that! The anatomically correct name for that part of the body is the abdomen. The abdomen is home to important organs including the liver, gallbladder, spleen, pancreas, and towards the back, the kidneys.

So when we as radiologists are asked to look into someone’s belly, we have a lot to check out! Pain in the abdomen can arise from issues with any of the  organs, the blood vessels and ducts or even the supporting tissues. Because there is so much to see, we select our tools very carefully – starting with ultrasound technology.

Ultrasound is great because images are made with harmless sound waves instead of radiation. It is fast, noninvasive, and painless. The most uncomfortable one might feel is when the tender area is evaluated in the scan. In short, it’s an easy exam.

Once the gel is applied, a transducer (fancy name for a probe) is rubbed gently across the skin. A computer calculates black, white and grey images in real time, instantly showing on a screen. Your radiologist can then interpret those images and determine what’s healthy, or what needs to be healed.

When you have a focal symptom, such as a pain, we can look specifically at the area in question, even viewing it with you in different positions (as in, it hurts right here when I do this!). Flank pain (“renal colic”), especially in young patients, those who are pregnant, and those with known kidney stones are excellent candidates for abdominal ultrasound. Right upper quadrant pain or pain after eating fatty foods can be due to gallstones – best seen and evaluated by ultrasound. Right lower quadrant pain can be an indicator of appendicitis and in kids and young adults ultrasound is a great first imaging test.

No matter what the diagnosis, it’s important to take care of your belly – and all that it holds! Ultrasound is a powerful tool in helping us help you.

(Image Credit: uplifting buddha by faria! via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

December 12, 2014

The ABC’s of Delivery Date Discovery

1024px-Mother_Kissing_BabyWhen is your baby due? This is one of the first  questions you will face from loved ones and strangers alike when you are pregnant. Determining the due date of your pregnancy, or the estimated delivery date (EDD) as we call it, means more than knowing what sign your child will be born under. It is vital to a healthy delivery.

 

An accurate due date is key to preventing pre- and post- term births and their related problems. Premature birth is associated with complications for the baby – postdate births pose different issues for baby and mom. An accurate due date is also key to evaluating fetal growth rate during the pregnancy. Inadequate growth is a serious issue for baby. Timing of obstetric care, especially knowing when it is necessary to induce labor (or NOT!) is best managed when a precise due date is known.

 

So, how does one accurately determine a due date? Traditionally, due date was calculated based on the first day of your last menstrual period (LMP). However, only approximately 50% of women can recall that date accurately. Differences in menstrual cycles and time of ovulation also leads to variability in the age of the pregnancy when based solely on LMP. This leaves a lot to guesswork… Enter: ultrasound.

 

In October of 2014, several groups including the American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal-Fetal Medicine issued guideline recommendations for the use of ultrasound in determining due date. This is most accurately done in the first trimester (prior to 14 weeks).

Ultrasound measures fetal length, from which your due date can be accurately derived.

 

So, once you are pregnant, for the best health for you and your precious baby know your due date with accuracy! Ultrasound in the first trimester can help keep you and your pregnancy on the path to good health.

 

(Image credit: Mother Kissing Baby by Vera Kratochvil via Wikimedia Commons Copyright Public Domain)

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

April 29, 2014

Case Study: Pyloric Stenosis or “Why Babies Get Ultrasounds”

pyloric stenosis

pyloric stenosis

We don’t like to expose infants to radiation, however sometimes we need to take a look inside. (Cue celebratory music…) This is why ultrasound is so fabulous! It’s real-time, harmless, noninvasive, short-lived and highly helpful.

 

Today’s case study covers an instance of an 8-week-old male infant with pyloric stenosis. Classically this disorder occurs at 2-8 weeks of age in male infants. The disorder is most common in Caucasian males and can run in families. The infants present with forceful projectile vomiting that can get progressively worse. Poor weight gain often results. Such was the case with this little one.

 

Today, we use ultrasound to image kids that are suspected of having pyloric stenosis (back in the old days we made the diagnosis with an upper GI exam done with fluoroscopy and X-rays – no longer necessary for the majority).  With ultrasound we use a probe gently placed on the baby’s abdomen to image the pylorus, a muscle which sits at the connection between the stomach and the small intestine. Ultrasound allows us to see the overdeveloped muscle that causes blockage between the stomach and the small intestine, impeding the progress of milk out of the stomach – vomiting and weight loss follow!

 

This condition is highly treatable after the diagnosis is made. Most often, simple surgery to open the muscle is used to put an infant back on track to weight gain and health. Here’s one more example of how ultrasound has impacted little lives. We love to image soundly!

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

April 1, 2014

The Places You’ll Go, the Things You’ll See… Imaging in Other Countries

Guest blogger, Rebecca

Guest blogger, Rebecca

Rebecca is our guest blogger today, one of our many great employees who make DIC what it is, committed to service not only here but in areas of great need…

We are proud of Rebecca for what she brings to our patients here and for her commitment to sharing her knowledge and compassion with those in need around the world.

 

Oh, The Places You’ll Go (by Dr. Seuss)

“You have brains in your head

You have feet in your shoes

You can steer yourself any direction you choose…”

This book was, and probably still is, a very popular graduation gift.  As young adults, the path to the future is wide open and many times uncertain.  I can say that I never imagined going to x-ray school then to ultrasound school in Kansas would lead me to Guatemala and Haiti to share that knowledge.

Luckily with time technology is catching up with the human need for quality healthcare.  The generosity of the American Society of Radiologic Technology and Rad-Aid who sponsored our Haiti trip and the Emporia United Methodist Church who sponsored the Guatemala trip is greatly appreciated.

Diagnostic Imaging Centers is committed to:  Dedication, Innovation, and Compassion.  All three are brought to our local community, but we also can bring those attributes to people in need – even in other countries.

Dedication:  Promoting patient care and safety. In Guatemala and Haiti, the maternal death rate during childbirth is high due to lack of knowledge of placenta location (placenta previa) or fetal position in the womb.  I was able to help instruct a midwife to learn these critical skills with ultrasound imaging. The Guatemalan midwife told our group that we were helping bring her dream of quality heathcare to reality and advance them to a higher level of care.  The dedication of many radiology personnel has helped form organizations for radiology medical missions. (For more information: www.odimguatemala.org)

Innovation:  The progressive innovation of increasingly smaller and truly portable ultrasound machines has helped bring quality healthcare to the poverty stricken and remote areas of the world.  But now the need is for trained professionals to teach the local doctors and potential students to use this equipment to the benefit of their patients.

Since the Haiti earthquake four years ago, most all healthcare supplies have been made available through donations.  Medical schools are open, but education for critical support staff such as technologists is limited.  At my location in Haiti, Hospital Bernard Mevs, there is a radiologic technologist school, but only one book to share among 6 students.  There is not currently an ultrasound technologist school.

The Rad-Aid group I was with hopes to change that reality. During the week in Haiti, we were doing lectures and hands-on training for the 1st class of Haitian radiology residents in 8 years, surgeons, and a few medical students.  A week is not enough time for proficiency, but with self motivated practice, internet capability to learn, donated textbooks (thanks to DIC‘s Dr. Linda Harrison), and hopefully future medical mission groups, we see a bright future for Haiti and other areas in need.

Compassion:  Compassion, consideration for another person, and living a life of service for others helps me enjoy my job and helped motivate me to search out these medical missions.

In Haiti, I did an obstetrical ultrasound on a 38 yr. old woman that had been in a car wreck, had a head injury, and bilateral mandible fractures.  She was 22 weeks pregnant at the time, and had never seen or knew about ultrasound before that day.  Due to machine and bed position, she was unable to watch the monitor.  And, unlike the USA, there was no picture printing or CD availability to provide her with images of her baby.  So, I took screen pictures of the baby on my camera to show her.

Though she had some memory loss and confusion, she was able to recognize her baby’s face.  The love that showed in her eyes and the smile on her face, I will never forget.  In Guatemala, my translator and I were able to attend a home visit with the midwife of a new mom and her infant son.  We brought her a gift for the baby and thanked her for allowing us to visit.  She said she wanted to thank us for wanting to meet them and learn about their culture.

In conclusion, I would like to encourage everyone to get involved with a group that supports your passion and to take that leap of faith to broaden your horizons.  It’s not always going to be easy and what you experience may not be easy to comprehend, but it will help make a better you and a better world.  I never thought my love of ultrasound, travel and service could be brought together, but now I can’t imagine separating them.

March 27, 2014

Ultrasound and Pregnancy: The Third Trimester

Whoa. Third trimester!

Whoa. Third trimester!

The third trimester of pregnancy can be a kick in the ribs – literally! As the newest member of your family grows and moves, the closer the crown of the head moves toward the birth canal. This is something of a slow somersault. Often times, it’s noticeable by the kicking-in-new-places.

But sometimes it’s not readily obvious. This doesn’t necessarily mean anything is wrong, but that may be a moment when your doctor would order a third trimester ultrasound.

Here’s What To Expect:

Third trimester ultrasounds are less common but not unheard of. Just as during the first or second term ultrasound, measurements can be taken to confirm size and due date.

Here’s What You’ll See:

This ultrasound can be used to look for fetal development, size, fluid and position.  The examination is typically performed by scanning with the probe on mom’s abdomen.  It is uncommon to perform transvaginal fetal ultrasound during the third trimester.

So, if you don’t need a third trimester ultrasound – that’s totally fine. As doctors we try to be judicious about the use of imaging. Again, while an ultrasound is harmless, why go in for unnecessary tests? If your doctor does recommend a third trimester ultrasound, again – don’t worry. We simply want the best possible health – for all!

If you’d like some really comprehensive further explanations of ultrasound and pregnancy, we recommend this link.

 

Diagnostic Imaging Centers blogs regularly about women’s health at www.mammographykc.com and general radiology here at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

March 25, 2014

Ultrasound and Pregnancy: The Second Trimester

Normal 28 week fetus on second trimester ultrasound. We're getting bigger now Mom!

Normal 28 week fetus on second trimester ultrasound. We’re getting bigger now Mom!

While the first ultrasound of a pregnancy is necessary to confirm pregnancy and initial health of the fetus and the mother, there’s more to come!

Ultrasound: 2nd Trimester Pregnancy

The second trimester ultrasound is a fun one! Now, ultrasounds are not entertainment – they are a medical screening and we doctors take them seriously for the sake of the health of all.

Luckily, ultrasounds do not involve radiation so they are safe and non-invasive. Whereas a first trimester ultrasound requires what is known as a transvaginal probe, the second trimester is done entirely externally unless there are special circumstances with mom or the baby.

What to Expect

You will be asked to come to the exam with a full bladder – we actually use the full bladder as a “window” through which we can view the pregnancy.

The exam with the bladder full will be done using a transducer across your belly to get a good evaluation of the uterus and your pelvis. This is most helpful in demonstrating the pregnancy location and fetus position.

The whole process will take about half an hour.

So… what’s the fun? Want to know if it’s a boy or girl? Want to see a clearer picture of the fetus? Now’s the time! Because most people wait until the second term to announce their pregnancy to friends and family, these images often appear on places like Facebook as the first introduction of who’s-to-come. That’s a lovely bonus.

What We Can See

But the serious side of a second term ultrasound is to determine a few important things. First, we want to confirm size and due date for this pregnancy making sure the fetal size and expected due date match up. We also want to confirm overall fetal health while performing a fetal anatomic survey. This means we can see development of the fetus and detect any possible problems. If there is any point of concern by second trimester ultrasound study often more detailed ultrasound, fetal echocardiography or other imaging can be planned to further evaluate any potential problem.

Ultimately, the second ultrasound is something to look forward to. Great information comes from the second trimester ultrasound regarding the health and welfare of mom and her baby. And, ok, it’s a little fun too.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health here at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

March 20, 2014

Ultrasound and Pregnancy: The First Trimester

Normal 12 week fetus on first trimester ultrasound. Hi Mom!

Normal 12 week fetus on first trimester ultrasound. Hi Mom!

When most people hear the term “ultrasound” one particular thought comes to mind: pregnancy. Every expectant parent loves a glimpse of who’s-to-come – and finding out which color to paint the nursery is a bonus for many!

However, ultrasound is far more powerful than simply providing in utero baby snapshots. Ultrasound has revolutionized the approach to pregnancy, giving information which can save lives – the baby’s or the mother’s or sometimes both. Ultrasound uses sound waves – not radiation – to produce images, so in trained hands it is safe to use at any time during pregnancy.

During the first trimester, ultrasound is used most frequently to confirm pregnancy (along with a blood test), to confirm the location of the pregnancy and to evaluate bleeding. In the first trimester, the ultrasound will likely involve images obtained through a distended bladder and a transvaginal exam.

Here’s what to expect:

First, you will be asked to come to the exam with a full bladder – we actually use the full bladder as a “window” through which we can view the pregnancy.

The first part of the exam with the bladder full will be done using a transducer across your belly to get a view of the uterus and your pelvis. This is most helpful in demonstrating the pregnancy location. Once these images are obtained, you will be able to empty your bladder and return for what is called a transvaginal ultrasound. This involves a small probe being placed into the vagina to image the pregnancy and pelvic structures. This transducer allows better depiction of the pelvic structures and will allow more detailed evaluation – this is used in the first trimester and occasionally later in pregnancy. In the first trimester when the pregnancy is so small, the transvaginal part of the study is often key. There is usually little or no discomfort with the transvaginal study.

The whole process will take about half an hour.

What can we see in the first trimester?

It depends on the age of the pregnancy. When first visualized, the pregnancy will be a small fluid filled sac. At around 6.5  weeks, the embryo is often seen as a small peanut shaped structure – heart beating away. By the end of the first trimester, you can distinguish the head, trunk and the limbs. Everything is small, so in general gender will not be determined. We will evaluate the age of the pregnancy and compare to what you should be; confirm that the pregnancy is in the uterus; count babies – twins anyone? – look for the heartbeat, which we can only see once the embryo is big enough (7 mm is the key embryo size to expect to see a heartbeat!); and look at the pelvic structures. Fetal anatomic detail is limited by the small size, but it is amazing what you can see!

We know having babies is stressful – and not always easy! We wish you all the best, and hope this helps explain the process of the first trimester obstetric ultrasound.

March 6, 2014

Ultrasound for Appendix

Here is an example of appendicitis by ultrasound with a tubular darker gray structure at the site of symptoms corresponding with the inflamed appendix.

Here is an example of appendicitis by ultrasound with a tubular darker gray structure at the site of symptoms corresponding with the inflamed appendix.

Appendicitis is pretty common – about 680,000 people – both kids and adults – will be affected by appendicitis each year – that’s about 1 per minute in the US! The appendix is a blind-ending tube with no apparent function that extends off the first part of the colon or large intestine, in the right  lower part of the abdomen, near the hip bone.

Appendicitis may be diagnosed purely on physical signs and symptoms (right lower quadrant pain, focal tenderness, fever and elevated white blood cell count) in some patients. If the diagnosis is questioned and imaging is needed, there are several options. Ultrasound is a great first step because it is noninvasive, quick, easy and involves no radiation. Imaging right where the patient is symptomatic is also quite helpful and easy to do with ultrasound.

With ultrasound, images with gentle, slow, graded pushing on the area of symptoms in the right lower quadrant are obtained with a transducer or probe. Appendicitis shows up as a tubular structure that does not push out of the way or compress, often with changes in the adjacent fat from the inflammation. This will often cause the patient to say, “Ouch, that is where it hurts.” If the symptoms are NOT related to the appendix, ultrasound can also help identify other potential sources of pain in the area, such as ovarian cysts, problems with the kidney or problems with the small bowel among lots of other causes.

If the ultrasound is inconclusive but symptoms persist, a CT scan is also an option for evaluation of the right lower quadrant.

There are many causes for pain in the lower right abdomen – if you have symptoms, see your doctor. Your doctor – with or without the help of your friendly radiologist – can work to determine the cause of your pain and treatment needed to get you back to good health.

February 25, 2014

What Is Ultrasound?

Philips - Ultrasound EPIQ - Abdominal by Philips Communications via Flickr Copyright Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Philips – Ultrasound EPIQ – Abdominal by Philips Communications via Flickr Copyright Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Today we will focus on another imaging technique that has revolutionized the practice of medicine in the past 3 decades. Ultrasound is a noninvasive form of imaging which uses sound waves to create images of the body. That’s right – sound waves!

An ultrasound technologist, also known as a sonographer, uses a transducer (probe) on the surface of the skin, connected to a computer. The transducer transmits sound waves into the body and then receives the sound waves as they come back to the transducer after they travel through and are reflected in the body. DIfferent tissues reflect and transmit the sound waves differently, allowing images to be created. A warm gel is applied to avoid air between the probe and the skin which can interfere with transmitting the sound waves.

How does it differ from other imaging techniques?

  • Firstly, ultrasound uses no ionizing radiation. It is a safe technique when performed properly with little risks to the patient, making it ideal for use in the young or pregnant patient.

  • Ultrasound can be used real-time, meaning images can be obtained while the patient is moving. This is particularly useful when studying things like joints or in directly assessing the exact site of symptoms.

  • The patient can be examined in different positions – for evaluating some structures, like leg veins, it may be helpful to examine the patient when they are upright. Joints may also require changes in patient position.

  • The machines are small – and getting smaller. For patients in the hospital, this means that the machine can be brought to the patient, rather than requiring the patient to move.

  • Doppler is an ultrasound technique which allows the study of blood flow, helpful in assessing many parts of the body, from the arteries in the neck to blood flow in the kidneys.

If you hear ultrasound and conjure images of pregnant women getting ultrasounds, you are not alone. Many are unaware of the number of applications of the technique in the body. With ultrasound, we can image most any part of the body – from the head to your toes and all parts between.