ABDOMINAL ULTRASOUND SCAN

Abdominal Ultrasound


Ultrasound equipment
  • What is Ultrasound Imaging of the Abdomen?
  • What are some common uses of the procedure?
  • How should I prepare?
  • What does the equipment look like?
  • How does the procedure work?
  • How is the procedure performed?
  • What will I experience during and after the procedure?
  • Who interprets the results and how do I get them?
  • What are the benefits vs. risks?
  • What are the limitations of Abdominal Ultrasound Imaging?

What is Ultrasound Imaging of the Abdomen?


Ultrasound of spleen and left kidney--Patient lying on back head to left.
Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound examinations do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
An abdominal ultrasound produces a picture of the organs and other structures in the upper abdomen.
A Doppler ultrasound study may be part of an abdominal ultrasound examination.
Doppler ultrasound is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck.

What are some common uses of the procedure?


Gallbladder and common bile duct.

Ultrasound: Gallbladder
Abdominal ultrasound imaging is performed to evaluate the:
  • kidneys
  • liver
  • gallbladder
  • pancreas
  • spleen
  • abdominal aorta and other blood vessels of the abdomen

Power Doppler ultrasound of the kidney.
Ultrasound: Kidney
Ultrasound is used to help diagnose a variety of conditions, such as:
  • abdominal pain or distention.
  • abnormal liver function.
  • enlarged abdominal organ.
  • stones in the gallbladder or kidney.
  • an aneurysm in the aorta.
Additionally, ultrasound may be used to provide guidance for biopsies.


Ultrasound: Liver
Doppler ultrasound images can help the physician to see and evaluate:
  • blockages to blood flow (such as clots).
  • narrowing of vessels (which may be caused by plaque).
  • tumors and congenital vascular malformation.

How should I prepare?

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.
Preparations depend on the type of ultrasound you are having.
  • For a study of the liver, gallbladder, spleen, and pancreas, you may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for eight to 12 hours before the test.
  • For ultrasound of the kidneys, you may be asked to drink four to six glasses of liquid about an hour before the test to fill your bladder. You may be asked to avoid eating for eight to 12 hours before the test to avoid gas buildup in the intestines.
  • For ultrasound of the aorta, you may need to avoid eating for eight to 12 hours before the test.

What does the equipment look like?

Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a transducer that is used to do the scanning. The transducer is a small hand-held device that resembles a microphone, attached to the scanner by a cord. The transducer sends out inaudible high frequency sound waves into the body and then listens for the returning echoes from the tissues in the body. The principles are similar to sonar used by boats and submarines.
The ultrasound image is immediately visible on a video display screen that looks like a computer or television monitor. The image is created based on the amplitude (strength), frequency and time it takes for the sound signal to return from the area of the patient being examined to the transducer and the type of body structure the sound travels through.

How does the procedure work?

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships, fishermen and the weather service. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is and its size, shape and consistency (whether the object is solid, filled with fluid, or both).
In medicine, ultrasound is used to detect changes in appearance of organs, tissues, and vessels or detect abnormal masses, such as tumors.
In an ultrasound examination, a transducer both sends the sound waves and receives/records the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off of internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Small loops of the moving “real time” images may also be saved.

Ultrasound of abdominal aorta. Color flow and spectral doppler.
Doppler ultrasound, a special application of ultrasound, measures the direction and speed of blood cells as they move through vessels. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and creates graphs or color pictures that represent the flow of blood through the blood vessels.

How is the procedure performed?

For most ultrasound exams, the patient is positioned lying face-up on an examination table that can be tilted or moved.
A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The sonographer (ultrasound technologist) or radiologist then presses the transducer firmly against the skin in various locations, sweeping over the area of interest or angling the sound beam from a farther location to better see an area of concern.
Doppler sonography is performed using the same transducer.
When the examination is complete, the patient may be asked to dress and wait while the ultrasound images are reviewed.
This ultrasound examination is usually completed within 30 minutes.

What will I experience during and after the procedure?

Most ultrasound examinations are painless, fast and easy.
After you are positioned on the examination table, the radiologist or sonographer will apply some warm water-based gel on your skin and then place the transducer firmly against your body, moving it back and forth over the area of interest until the desired images are captured. There is usually no discomfort from pressure as the transducer is pressed against the area being examined.
If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.
If a Doppler ultrasound study is performed, you may actually hear pulse-like sounds that change in pitch as the blood flow is monitored and measured.
Once the imaging is complete, the gel will be wiped off your skin.
After an ultrasound examination, you should be able to resume your normal activities immediately.

Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care physician or the physician who referred you for the exam, who will share the results with you. In some cases the radiologist may discuss results with you at the conclusion of your examination.
Follow-up examinations are often necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may be necessary so that any change in a known abnormality can be detected over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable over time.

What are the benefits vs. risks?

Benefits

  • Most ultrasound scanning is noninvasive (no needles or injections) and is usually painless.
  • Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
  • Ultrasound imaging does not use any ionizing radiation.
  • Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
  • Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and needle aspiration.

Risks

  • For standard diagnostic ultrasound there are no known harmful effects on humans.

What are the limitations of Abdominal Ultrasound Imaging?


Ultrasound showing blood flowing from intestines into liver. Image on the left: routine. On the right with power Doppler.
Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique for air-filled bowel or organs obscured by the bowel. In most cases, barium exams, CT scanning, and MRI are the methods of choice in this setting.
Large patients are more difficult to image by ultrasound because greater amounts of tissue attenuates (weakens) the sound waves as they pass deeper into the body.

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