US Ch 2

Echoes

SW that reflect back to the US probe after traveling through tiss

• can be seen on the screen as as dots, the more echoes there are from 1 spot → the brighter it is displayed on the screen

Echogenicity

the scanner translates the echoes it receives on the transducer into pixels on the screen

Homegeneous

struc w sim components

Heterogeneous

struc of diff composition

Hyperechoic

• struc that produces many echoes → brighter color

• may prod posterior shadowing

Hypoechoic

• having few echoes w/in a struc → darker color

• comparative term

Anechoic

• has no echoes → black color

• fluid filled strucs

• prods acoustic enhacnement

What are the cornerstones of patient care?

• sympathy

• empathy

• altruism

• compassion

• honesty

• friendliness

Why is US so important?

Us is the most operator dependent imaging modality

• the patients exam is only as good as the image taken

• if you miss it → it doesn’t get found

What are the 5 steps of sonographic reasoning?

step 0= the requested exam

1. clinical history

2. clinical hypothesis

3. investigative imaging

4. sonographic findings

5. clinical correlation → recall clin hist + hypo

Echotexture

the visualized internal composition or pattern of echoes w/in an individual struc

What does complex texture mean?

mixed components, solid + cystic

Acoustic/posterior enhancement

the increased echoes deep to strucs that transmit sound exceptionally well

• a characteristic of fluid filled strucs like cysts, the urinary bladder, + the gallbladder

Acoustic shadowing

a form of US artifact characterized by the apparent lack of signal to an imaged tiss interface

• due to all of the transmitted SW being reflected back to the transducer

Where does shadowing commonly occur?

in an area containing a high calcified gallstone or bone at an interface w high acoustic impedance mismatch

Echogenic

• struc that prods echoes

• bright or gray on image

• comparative term

Isoechoic

• having mixed echogenicities

• a struc that has both fluid + solid components

What are the clinical findings of acute cholescystitis?

• elev bilirubin + ALP

• leukocytosis

• sudden onset of RUQ pain

• nausea + vomitting

• no past abd surgeries

• no prev imaging studies

Sonographic findings of acute cholecystitis?

• normal liver, pancreas

• gallstones

• gallbladder wall thickening

• pericholecystic fluid

• murphy sign (pain to press)

Sagittal view

• length + height

• ant/post

• sup/inf

Transverse view

• width

• ant/post

• right/left