Posts tagged ‘us’

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))

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

Task Force Guidelines on Aorta Screening in Smokers

Vincent Willem van Gogh (self portrait) Copyright Public Domain

Vincent Willem van Gogh (self portrait) Copyright Public Domain

This is a call to older male smokers. As a smoker you are at risk for many health issues. While heart and lung conditions are the more commonly known diseases for smokers, vascular diseases are another. Abdominal aortic aneurysm, or “AAA,” is yet another significant health issue that may be seen with higher frequency in smokers. An aneurysm is an abnormal ballooning or dilatation of a blood vessel. In this case, the aneurysm involves the aorta – the main artery carrying blood to the abdomen and lower body. As the aneurysm gets bigger, there is a risk of sudden death from rupture.

Recently the USPSTF, a task force that reviews guidelines and screening studies, came forward with a recommendation with the intention of saving lives. The Task Force has issued a recommendation for ultrasound screening of male smokers over the age of 65 for the presence of an abdominal aortic aneurysm. Further research is needed to determine the usefulness of the screening test both in women who smoke and in older male non-smokers.

Making use of the simple non-invasive technology of ultrasound, one-time screenings for men in the high risk category will help improve survival from complications of abdominal aortic aneurysm. For more on the recommendation, we recommend this resource.

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.