UTZ RTE pt, 3

Bladder Polyps

Appear as small, echogenic masses protruding into the bladder cavity

They are usually benign and lack posterior shadowing

Calculi

Echogenic focus within bladder with posterior acoustic shadowing

Hematomas

Echogenic or complex mass within bladder and may fill bladder completely

Acute cystitis

● Often shows bladder wall thickening (>3-5 mm) with increased echogenicity

● The wall may appear irregular or edematous

● In severe cases, debris or echogenic material (sludge) can be seen within the bladder, indicating pus or inflammatory cells

Chronic cystitis

● Result in diffuse bladder wall thickening and reduced bladder capacity due to fibrosis

Ureterocele ● A round

A round or oval cystic structure at ureteral orifice that may cause hydronephrosis and can vary in size as they fill and empty with urine

Urinary retention

● Results in a significantly distended urinary bladder that may extend into the upper abdomen

● Bladder volume estimation can be performed by measuring width, length, and height

● Normal maximum bladder volume — for adults, the bladder can hold approximately 400 to 600 mL comfortably

Benign Prostatic Hyperplasia (BPH)

● Enlarged gland, with a hypoechoic or heterogeneous echotexture.

● Often shows protrusion into the bladder.

● Associated findings: Post-void residual urine if BPH cause bladder outlet obstruction

Prostate cancer ● Often appe

● Often appears as a hypoechoic (dark) lesion. However, some cancers can be isoechoic or hyperechoic.

● Increased vascularity on color Doppler may indicate malignant tissue

Prostatitis

● Present with an enlarged, heterogeneous prostate with hypoechoic areas or fecal abscesses

Prostate cysts

Anechoic round structures within the gland, with thin walls and no internal echoes

Gestational sac

Visible as early as 4.5 to 5 weeks of gestation via transvaginal ultrasound

Yolk sac

Appears around 5 to 5.5 weeks

● It’s the first visible structure inside the gestational sac and confirms intrauterine pregnancy

Embryo (fetal pole)

Usually visible by 5.5 to 6 weeks

Heartbeat, 6 weeks

Detected as early as ____ by transvaginal ultrasound

● By 7 weeks, the heartbeat should be visible and regular, with an average rate of 110-160 bpm

around 16 weeks (depends on fetal position and clarity) ● More reliable: between 18 to 20 weeks during anatomy scan

When will the baby’s gender be revealed?

Congenital Anomaly Scan

Done at 18 to 22 weeks gestation

Reverberation

Highly reflective interface is located near the patient surface

Ring-Down Artifact

A tail of very fine echoes produced from small gas bubbles ● long, continuous, non-tapering streak of bright echoes

● Group of small gas bubbles

Comet Tail Artifact

Creates multiple echoes that decrease in intensity with depth

● short, closely spaced, bright echoes that taper off, forming a “tail-like”

● Metallic objects like surgical clips or small calcifications

Shadowing

● A dark (hypoechoic or anechoic) area directly behind a highly reflective or absorbing structure

● Bones, calculus (gallbladder/kidney), calcifications

Enhancemen

Refers to a bright (hyperechoic) area that appears behind a structure that transmits sound waves with little attenuation (loss of intensity)

Mirror Artifact

occur when the ultrasound beam encounters a highly reflective non-perpendicular or curved boundary such as the diaphragm

● A structure is duplicated, often appearing as a mirror image on the opposite side of a strong reflector (e.g., diaphragm)

● diaphragm, pleura, heart, liver

Refraction / Duplication

occurs when the ultrasound beam passes through two tissues with different acoustic impedances at an oblique angle, causing the beam to bend

● Commonly seen around curved structures such as the rectus muscles of the abdomen or when imaging through the edge of the gallbladder or the urinary bladder

Side Lobes

are weaker ultrasound beams that are emitted from the transducer at angles different from the main central beam ● Additional, faint structure in the image, often overlapping the true anatomy or appearing in unexpected areas; “ghost image”

● gallbladder, diaphragm, or blood vessels

Focusing

is a process used to further improve the beam width so that it is narrowest at the focal zone

Attenuation Artifacts

occur when there is a reduction in the intensity of the ultrasound beam as it travels through different tissues

Increased Through Transmission Artifacts

Occurs when sound waves pass through a structure with low acoustic impedance, resulting in stronger echoes from the tissues located behind that structure.

1.) Aliasing — “wraparound effect”

2.) Range ambiguity

3.) Temporal ambiguity

4.) Angle of Insonation

5.) Doppler Mirror artifact

DOPPLER ARTIFACTS