chapter 6

suspine

laying on your back

prone

lating on your stomach

RLD

Right lateral decubitus (right side down)

LLD

Left lateral decubitus (left side down)

erect

sitting straight up

semi erect

semi straight up

subcostal

probe is angled superiorly just below the ribs

intercostal

between the ribs

sweep

angling from one side all the way to the other

slide

sliding the probe

angle

angling probe left or right (sag) or up and down (trans)

heel toe

rocking the probe from one end to the other

longitudinal (sag) image annotations

long midline, lateral, medial

transverse image annotations

trans lower, mid, high, trans upper, mid, inferior

transverse

patients right side is on the left of the screen and vice versa

longitudinal (sag)

patients head is on the left of the screen, feet on the right

anechoic/sonolucent

without echoes, dark on the image, fluid-filled structures, (ex gallbladder, urinary bladder, simple renal cyst)

echogenic

bright white structures that is capable of producing echoes by reflecting the acoustic beam (ex bone, fat, gallstone)

hyperechoic

high level echoes within a structure, appears brighter to surroundings

hypoechoic

low level echoes within a structure, appears darker to surroundings (ex lymph, fibroma)

isoechoic

very similar to normal tissue pattern, structure may appear to blend in

enhancement

also referred to as increased through transmission, structure is anechoic, tissue behind it is echogenic

fluid fill level

interface between two fluids with different acoustic characteristics

heterogeneous

NOT uniform in texture or composition

homogeneous

COMPLETELY uniform in texture or composition

infiltrating

diffuse disease process or metastatic diseases in entire area

focal

diffuse disease process or metastatic diseases in one area

irregular borders

not well defined or absent borders

smooth borders

well defined smooth borders

cyst

smooth well defined borders, anechoic, increased through transmission

complex

characteristics of both a cyst and a solid structure

solid

irregular borders and internal echoes, decreased through transmission

Portal Triad Components

Portal vein, Common bile duct, Hepatic artery

Common bile duct visualization sagittal/longitudinal

Anterior to portal vein, which is anterior to IVC

common bile duct visualization transverse

Seen alongside portal vein and hepatic artery (Mickey Mouse sign)

portal vein blood flow direction

toward the liver (hepatopetal), supplies ~70% of liver blood flow

hepatic vein blood flow direction

away from the liver (hepatofugal), drains blood into the IVC and toward the heart

arterial waveform

(ex aorta) pulsatile with high systolic peaks, reflects cardiac cycle

venous waveform

(ex IVC, hepatic) continuous or phasic with respiration, low velocity, non-pulsatile, hepatic vein may show mild pulsatility due to right atrial pressure changes

anechoic or sonolucent

echogenic or hyperechoic