Ultrasound

For Members:

Ultrasound:

• Ultrasound is also called sonography.
• Ultrasound is an imaging technique, bouncing sound waves far above the level of human perception through interior body structures. The sound waves pass through different densities of tissue and reflect back to a receiving unit at varying speeds. The unit converts the waves to electrical pulses that are immediately displayed in picture form on a computer screen, to determine the size, shape, and consistency of soft tissues and organs.
• Real time scanning displays both two-dimensional structure images and movement with time.
• Images produced can be flat 2 dimensional, 3D and 4D where 3D images are seen in motion.
• Ultrasound technicians, or sonographers, have special training in performing the test. Then a radiologist or your Physician will interpret the ultrasound images to make diagnosis.
• During ultrasound, the technician will apply a water-based gel to the area, this helps the transducer (probe) can easily glide across your skin without any air in between.
• Typically an ultrasound takes between 30 minutes and an hour.
• Ultrasound imaging can help in some medical procedures such as needle biopsies.
• It can useful for detecting and treating soft-tissue injuries.
• It is a non-invasive, painless and harmless test with no radiations involved.
• It is readily available and affordable test.
• This technology is very helpful in diagnosing and treating certain conditions affecting heart and blood vessels, liver, gallbladder, spleen, pancreas, kidneys, bladder, uterus, ovaries, eyes, thyroid, and testicles.

Types of Ultrasound:

Depending on the organ being examined and the underlying disease, different transducers (probes) are used during Ultrasound. Based on the type of ultrasound test you are having, your Physician may provide special instructions, such as not eating or drinking anything for a number of hours before the test, or drinking or eating in certain quantity, always follow the instructions.

1- Abdominal Ultrasound

• Abdominal ultrasonography is most commonly used to obtain images of abdominal organs like, liver, kidneys, gall bladder and some parts of small intestine.
• It is usually performed after 8-10 hours of fasting. It can be difficult for patients with gas in intestine or obesity (belly fat).
• Abdominal ultrasound may be performed to assist in the placement of needles used for biopsy of abdominal tissue or to drain fluid from a cyst or abscess.
• It may also be used to assess the blood flow of various structures within the abdomen.
• Indications:
  • Abdominal, flank, and/or back pain.
  • Evaluation of urinary tract infection and hydronephrosis (kidney disease).
  • Evaluation of uncontrolled hypertension and suspected renal artery stenosis (collapse).
  • Search for the presence of free or loculated peritoneal and/or retroperitoneal fluid.
  • Evaluation of suspected congenital abnormalities.
  • Evaluation of suspected hypertrophic pyloric stenosis, intussusception, necrotizing enterocolitis, or any other bowel abnormalities.
  • Before and after transplantation evaluation.
  • Signs or symptoms that may be referred from the abdominal and/or retroperitoneal regions, such as
    • Jaundice or Hematuria (blood in Urine)
    • Palpable abnormalities such as an abdominal mass or organomegaly
  • Abnormal laboratory values or abnormal findings on other imaging examinations suggestive of:
    • Abdominal and/or retroperitoneal pathology.
    • Follow-up of known or suspected abnormalities in the abdomen and/or retroperitoneum.
    • Search for metastatic disease or occult primary neoplasm.
    • Evaluation of cirrhosis, portal hypertension, and Trans-jugular Intrahepatic Portosystemic Shunt (TIPS).
    • Stents; screening for hepatoma; evaluation of the liver in conjunction with liver elastography.
    • Abdominal trauma.
  • It can also be helpful in checking other abdominal conditions, like:
    •  Cysts
    •  Tumors
    • Collection of pus (abscesses)
    •  Obstructions
    • Fluid collection
    • Blockages (clots) in blood vessels

2- Pelvic Ultrasound:

• It is performed on the lower abdomen, that is, below umbilicus (belly button).
• It can be performed by placing a probe on lower abdomen directly or by inserting a small probe in the vagina.
• It may be necessary to use a transvaginal ultrasound to examine the following internal organs: Vagina, cervix, uterus, fallopian tubes, ovaries, urinary bladder and are also useful to check for ovarian cysts or tumors, fibroids and polyps.
• Transvaginal ultrasound is preferred over CT because of improved visualization of pelvic organs, the absence of radiation exposure with ultrasonography, decreased time of hospital stay, and reduced cost to the patient.
• Transvaginal ultrasound is not performed in virgin patients or if the patient is unable to tolerate internal examinations.
• Indications:
  • Evaluation of pelvic pain
  • Evaluation of pelvic masses
  • Evaluation of endocrine abnormalities, including polycystic ovaries
  • Evaluation of dysmenorrhea (painful menses)
  • Evaluation of amenorrhea (absence of menses)
  • Evaluation of abnormal bleeding
  • Evaluation of delayed menses
  • Follow-up of a previously detected abnormality
  • bleeding);
  • Excessive irregular bleeding (Menometrorrhagia)
  • Evaluation, monitoring, and/or treatment of infertility patients
  • Delayed menses
  • Postmenopausal bleeding
  • Signs or symptoms of pelvic infection
  • Evaluation of congenital anomalies (birth defects) during pregnancy
  • Abortion
  • Localization of a intrauterine contraceptive device (IUCD)
  • Screening for malignancy (cancer) in patients at increased risk
  • Urinary incontinence
  • Pelvic organ prolapse
  • Guidance for interventional or surgical procedures

3- Scrotal ultrasound:

• It can provide detailed pictures of scrotum, testicles, and the blood vessels. Doctors also call this test a “scrotal ultrasound.
• Your Physician might order this test if you have pain or swelling, or if you have a mass in the scrotum.
• It can also assist in identifying whether there is a cyst (fluid-filled sac), or torsion.
• An ultrasound can also be used to diagnose testicular cancer or problems with blood flow in the scrotum.
• Indications:
  • For Newborns/Infants/children:
    • To determine the presence of testes in the case of cryptorchidism.
    • Testicular pain.
    • Suspected orchitis and epididymitis.
    • Testicular and epididymal asymmetry.
    • Abnormal laboratory and tumor marker findings, e.g. alpha-fetoprotein and human chorionic gonadotropin (β-HCG).
  • For Adults:
    • Abnormal testicular consistency.
    • Suspected testicular tumors.
    • Scrotal or inguinal hernia.
    • Spermatic cord hydrocele.
    • Extra peritoneal and inguinal lymphadenopathy.
    • Hematospermia (blood in semen)
    • Reproductive failure.

For Healthcare Providers:

• All Ultrasound request/s require pre-authorization from Nextcare.

References:

• https://www.webmd.com/a-to-z-guides/what-is-an-ultrasound#1
• http://ncu-codefinder-dubai.tatsh.com/reference2/index.html?file=cptlinks.ref&topic=76811&RepId=1&countryName=UnitedArabEmirates&CodeRev=360
• https://www.uptodate.com/contents/transabdominal-ultrasonography-of-the-small-and-large-intestine?search=abdominal%20ultrasound&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
• https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/abdominal-ultrasound
• https://onlinelibrary.wiley.com/doi/10.7863/jum.2010.29.1.166
• Alcazar JL, Gaston B, Navarro B, et al. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: A systematic review and meta-analysis. J Gynecol Oncol. 2017;28(6):e86
• Guerriero S, Ajossa S, Orozco R, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: Systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2016;47(3):281-289.
• radiologyinfo.org/en/info.cfm?pg=us-scrotal