US301 Sonographic Exploration

Discussion 9

What is the primary goal of abdominal sonography?

To evaluate the abdominal organs and surrounding structures for normal anatomy, pathology, and functional abnormalities.

Why is proper patient preparation important for abdominal scanning?

Fasting for 6-8 hours reduces bowel gas and ensures gallbladder distention for optimal visualization.

What is the typical patient position for an abdominal ultrasound exam?

The patient lies in a supine position, but oblique, decubitus, or upright positions may be used for better organ visualization.

What type of transducer is most commonly used for abdominal imaging?

A curvilinear (convex) transducer with a frequency range of 2-5 MHz, providing deep penetration and a wide field of view.

What does the term "acoustic window" mean in abdominal scanning?

An area through which sound waves pass easily, allowing clear visualization of deeper structures (e.g., the liver acts as a window for the pancreas).

Why is breathing technique important during abdominal scanning?

Asking the patient to inhale and hold the breath lowers the diaphragm, improving visualization of upper abdominal organs like the liver and spleen.

What is the scanning protocol for an abdominal ultrasound?

Typically includes the liver, gallbladder, bile ducts, pancreas, spleen, kidneys, aorta, and inferior vena cava (IVC).

What is the purpose of using different patient positions during the exam?

To shift organs or bowel gas and obtain better acoustic windows, improving image quality and organ visualization.

How does bowel gas affect abdominal sonography?

It causes shadowing and reflection artifacts, which obscure underlying structures and reduce image clarity.

What is gain and why must it be adjusted during scanning?

Gain controls image brightness. Adjusting it ensures uniform echo intensity, preventing over- or underexposure of structures.

What is the importance of scanning in multiple planes (sagittal, transverse, oblique)?

Imaging in multiple planes allows for accurate localization, size measurement, and differentiation between normal and abnormal findings.

What are some key sonographic landmarks for abdominal scanning?

The aorta, IVC, portal vein, and ligamentum teres are common landmarks used for orientation and organ identification.

What are some of the artifacts?

reverberation, mirror, side lobe, shadowing

anechoic or sonolucent

opposite of echogenic; without internal echoes; the structure is fluid filled and transmits sound easiily

heterogeneous

not uniform in texture or composition

homogeneous

completely uniform in texture or composition

hypoechoic

low-level echoes within a structure

irregular borders

borders are not well-defined, are ill defined, or are not present

isoechoic

very close to the normal parenchyma echogenicity pattern

loculated mass

well-defined borders with internal echoes; the septa may be thin or thick

shadowing

the sound beam is attenuated by a solid or calcified object

echogenic or hyperechoic

opposite of anechoic; echo-producing structure; reflects sound with a brighter intensity

fluid-fluid level

interface between two fluid with different acoustic characteristics; this level will change with patient position

infiltrating

usually refers to a diffuse disease process or metastatic disease