UTZ RTE pt. 2

SONOGRAPHIC TERMS

Echogenicity

The ability of a structure to reflect sound waves

● Determines the brightness of tissues

Hyperechoic

Reflects more sound than surrounding tissue

. Isoechoic

Similar echogenicity to surrounding tissues

Hypoechoic

Reflects less sound than surrounding tissue

Anechoic

No sound is reflected

Echotexture

● Refers to the overall pattern and consistency of echoes within a tissue or organ on ultrasound

● It helps differentiate normal from abnormal structures

Homogeneous

Uniform echotexture, consistent echo pattern

Even gray, smooth appearnce

Heterogeneous

Mixed echotexture with areas of different echogenicity

Patchy or coarse texture

Amplitude mode

● Displays echoes as spikes along a single line

● Used primarily in ophthalmology for axial length measurements

Brightness mode

● Represents echoes as a 2D grayscale image, where brightness corresponds to echo intensity

● The most common mode in diagnostic ultrasound

Motion mode

● Captures the motion of structures (like heart valves) over time along a single ultrasound line

● Frequently used in echocardiography

DOPPLER MODE

● Evaluates blood flow by detecting frequency shifts due to the Doppler effect

Color Doppler

for visualizing flow direction and turbulence

Spectral Doppler

- for detailed velocity analysis

Power Doppler

for detecting low-velocity flow in small vessels

Duplex Doppler System

combination of a B-mode and Doppler system; allows the Doppler beam to be directed accurately at any particular blood vessels

Continuous Wave (CW) Doppler

Uses two crystals: one continuously sending ultrasound waves and the other continuously receiving returning echoes ○ Can measure very high blood flow velocities, making it useful in cardiology

Pulse Wave (PW) Doppler

Uses a single crystal that alternates between sending and receiving ultrasound waves ○ Provides depth specificity, meaning it can measure blood flow velocity at a precise location using a sampling gate

Focusing

● Improves resolution

● Can be electronic or lens-based

Amplification (TGC)

● Compensates for attenuation

● Enhances image quality

Boundaries

The line at the periphery of two tissues which propagate ultrasound differently

The zone of echoes at the interface

Wave Propagation Speed

The transmission and spread of ultrasound waves to different tissues

1540 m/s

4620 m/s

● Soft tissue average:

● Bone average:

Spatial Resolution

Detail resolution

The ability to display two structures situated close together as separate image

Longitudinal, Linear, Depth or Range

Characteristics of Axial Resolution

Axial Resolution

The ability to distinguish two objects parallel to the ultrasound beam

good

Short spatial pulse length: ___ axial resolution

Azimuthal, Transverse, Angular or Horizontal

Characteristics of Lateral Resolutioin

Lateral Resolutioin

The ability to distinguish two objects perpendicular to the ultrasound beam

better

Smaller beam width: ____ lateral resolution

Contrast Resolution

Differentiate tissue shades

Transducer

● Sends and receives sound waves

● Converts electrical energy into sound waves and back again

Central Processing Unit (CPU)

● The brain of the machine

● Processes raw echo signals and converts them into real-time images

Transducer Pulse Controls

Adjusts the amplitude, frequency, and duration of pulses sent to the transducer

Display Monitor

● Shows the real-time ultrasound image

● Used for observing and interpreting anatomical structures

Keyboard / Control Panel

● Used to input patient data and adjust scanning parameters (gain, depth, focus)

● Includes buttons, trackballs, and knobs for navigation

TGC (Time Gain Compensation) Sliders

Adjusts image brightness at different depths

● Compensates for attenuation as the wave travels deepe

Abdominal Ultrasound

● Evaluate liver, gallbladder, pancreas, spleen, and kidneys

● Detect gallstones, liver cirrhosis, or abdominal masses

● Assess for abdominal pain or trauma

Obstetrics and Gynecology Ultrasound

● Confirm pregnancy and gestational age

● Monitor fetal growth and development

● Check for fetal anomalies or placental position

● Evaluate menstrual irregularities or pelvic pain

Breast Ultrasound

Evaluate breast lumps or abnormalities seen on mammography

● Guide needle biopsies

● Differentiate between cystic and solid masses

Thyroid / Neck Ultrasound

● Evaluate thyroid nodules or enlargement

● Guide fine-needle aspiration biopsy (FNAB)

● Detect lymphadenopathy

Vascular / Doppler Ultrasound

● Assess blood flow in arteries and veins

● Detect deep vein thrombosis (DVT)

● Evaluate carotid artery stenosis

Musculoskeletal (MSK) Ultrasound

Visualize tendons, ligaments, joints, and soft tissues ● Diagnose tears, inflammation, or fluid collections ● Guide joint injections

Renal / Urinary Tract Ultrasound

● Evaluate kidney size, shape, or obstruction ● Detect renal stones or hydronephrosis ● Assess bladder post-void residual

Prostate Ultrasound (Transrectal)

● Evaluate prostate size or abnormalities ● Guide prostate biopsy ● Investigate elevated PSA or urinary symptoms

Anterior

Posterior

Superior

Inferior

1. Sagittal Scanning Plane

Anterior

Posterior

Right Lateral

Left Lateral

Transverse Scanning Plane

Lateral (Right or Left)

Medial

Superior

Inferior

. Coronal Scanning Plane

In the coronal and sagittal scanning plane

the probe indicator should be directed toward the patient’s head (superior), meaning it will be oriented cephalad

In transverse scanning plane,

the probe indicator should be oriented toward the patient’s right side.

Normal

Homogeneous echotexture, smooth borders

Fatty Liver (Hepatic Steatosis)

Increased echogenicity of liver compared to the renal cortex

Hepatitis

Diffuse liver enlargement, possible increased echogenicity, and irregularities

Cirrhosis

Shrunken liver with a nodular surface and possible ascites

Liver Tumors

Focal lesions (e.g., hemangioma, hepatocellular carcinoma), which may appear hypoechoic or hyperechoic

Abscesses

Hypoechoic lesions with irregular borders

Splenomegaly

Enlargement due to various causes, including infections, liver disease, or hematologic disorders

Splenic Abscess

Hypoechoic lesion within the spleen with potential irregular borders

Splenic Infarction

Wedge-shaped hypoechoic areas indicating tissue death

Cysts

Anechoic lesions within the spleen, usually benign

Normal

Anechoic fluid-filled structure of the GB

Cholelithiasis (Gallstones)

Echogenic foci with posterior acoustic shadowing

Cholecystitis

Thickened gallbladder wall (>3mm), increased vascularity, and possibly pericholecystic fluid

Gallbladder Polyps

Echogenic lesions projecting from the gallbladder wall, typically <10mm in size

Hydrops

Enlarged gallbladder due to obstruction

Normal

Pancreas is Homogeneous echotexture, slightly hypoechoic compared to the liver

Pancreatitis

Enlarged, hypoechoic pancreas with possible fluid collections (pseudocysts)

Pancreatic Tumors

Focal hypoechoic lesions, which can be cystic or solid

Pancreatic Abscess

Hypoechoic areas with irregular borders and possibly gas within the lesion

Ductal Dilatation

Enlarged pancreatic duct, possibly indicating obstruction

Abdominal Aorta Aneurysm

focal dilation of the aorta, typically measuring >3 cm in diameter. It has an anechoic (black) lumen surrounded by echogenic walls

Atherosclerotic Plaque

appears as echogenic, irregular thickening along the inner aortic wall

Aortic Stenosis

appears as a focal narrowing with increased echogenicity due to plaques or calcification

Aortic Occlusion

shows an absence of color flow within the lumen on Doppler ultrasound. Echogenic material may fill the lumen, indicating thrombus or plaque

Cortical cyst

● Complex cysts may have septations and/or internal echoes caused by hemorrhage, infection, calcification, or less commonly, tumor

Lipomas

Well-defined echogenic mass usually less than 5 cm in diameter

Nephrolithiasis

Appears as echogenic (bright) spots with posterior acoustic shadowing

Hydronephrosis

Dilation of the renal pelvis and calyces due to obstruction, seen as an anechoic (dark) fluid-filled area in the renal sinus

Nephrocalcinosis

The renal cortex appears significantly hyperechoic compared to the normal surrounding renal tissue due to calcium deposits

Chronic Kidney Disease

Characterized by small, shrunken kidneys with increased cortical echogenicity and thinning

Acute Kidney Injury (AKI

Kidneys may appear normal or show increased size and echogenicity depending on the cause

Adult Polycystic Kidney Disease

● Early stage — enlarged kidneys with multiple cysts of various sizes

● Late stage — multiple cysts replacing renal parenchyma

Renal Masses or Tumors

May appear as solid or complex masses with varying echogenicity, sometimes with irregular borders

Pyelonephritis

Inflammation of the kidney may show as increased cortical echogenicity, loss of corticomedullary differentiation, or localized swelling

Renal Abscess

A fluid-filled collection with irregular borders, often with internal debris or septations

Simple cysts

appear as well-defined anechoic structures with thin walls and posterior acoustic enhancement

Complex cysts

may have septations, debris, or calcifications

Renal Trauma

May show hematomas, lacerations, or disrupted kidney architecture