Podcast
Questions and Answers
What is the primary purpose of the piezo-elements in the transducer during ultrasound imaging?
What is the primary purpose of the piezo-elements in the transducer during ultrasound imaging?
What does refraction in ultrasound imaging refer to?
What does refraction in ultrasound imaging refer to?
Which of the following is NOT a potential fault in ultrasound imaging?
Which of the following is NOT a potential fault in ultrasound imaging?
What is the result of the returning sound waves in ultrasound technology?
What is the result of the returning sound waves in ultrasound technology?
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What is one of the main advantages of abdominal ultrasound over radiography?
What is one of the main advantages of abdominal ultrasound over radiography?
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What happens when ultrasound meets a highly reflective interface?
What happens when ultrasound meets a highly reflective interface?
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Which term describes a structure that appears as a darker shade of grey in an ultrasound image?
Which term describes a structure that appears as a darker shade of grey in an ultrasound image?
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What type of ultrasound artifact is characterized by a shadow distal to the lateral aspect of a cystic structure?
What type of ultrasound artifact is characterized by a shadow distal to the lateral aspect of a cystic structure?
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What does an anechoic structure typically appear as in an ultrasound image?
What does an anechoic structure typically appear as in an ultrasound image?
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What artifact occurs when part of the ultrasound beam is wider than the cystic structure being assessed?
What artifact occurs when part of the ultrasound beam is wider than the cystic structure being assessed?
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What does TFAST primarily assess for in trauma cases?
What does TFAST primarily assess for in trauma cases?
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Which of the following describes the appearance of fluid in thoracic ultrasound?
Which of the following describes the appearance of fluid in thoracic ultrasound?
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In the Vet BLUE assessment, which lung lobe region is NOT included?
In the Vet BLUE assessment, which lung lobe region is NOT included?
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What type of ultrasound findings indicate the absence of the ‘glide sign’?
What type of ultrasound findings indicate the absence of the ‘glide sign’?
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In what situation would you prefer abdominal ultrasound over radiography?
In what situation would you prefer abdominal ultrasound over radiography?
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What is the primary cause of attenuation in ultrasound signals?
What is the primary cause of attenuation in ultrasound signals?
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Which ultrasound probe type offers a fan-shaped image with electronically steered beams?
Which ultrasound probe type offers a fan-shaped image with electronically steered beams?
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Which characteristic is associated with high frequency ultrasound?
Which characteristic is associated with high frequency ultrasound?
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What does the gain control in ultrasound equipment adjust?
What does the gain control in ultrasound equipment adjust?
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How does Time Gain Compensation (TGC) assist in ultrasound imaging?
How does Time Gain Compensation (TGC) assist in ultrasound imaging?
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What is lateral resolution in ultrasound imaging primarily influenced by?
What is lateral resolution in ultrasound imaging primarily influenced by?
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Which ultrasound artifact is characterized by parallel bright lines?
Which ultrasound artifact is characterized by parallel bright lines?
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What is the main advantage of focusing the ultrasound beam?
What is the main advantage of focusing the ultrasound beam?
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What is a characteristic of heterogeneous echotexture?
What is a characteristic of heterogeneous echotexture?
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Which of the following is NOT a roentgen sign used for describing a lesion?
Which of the following is NOT a roentgen sign used for describing a lesion?
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What is a primary indication for an elective abdominal ultrasound?
What is a primary indication for an elective abdominal ultrasound?
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Which of the following is a disadvantage of abdominal ultrasound?
Which of the following is a disadvantage of abdominal ultrasound?
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What is a benefit of performing an abdominal ultrasound?
What is a benefit of performing an abdominal ultrasound?
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What position is ideal for patient preparation during an abdominal ultrasound?
What position is ideal for patient preparation during an abdominal ultrasound?
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Which echocardiography technique provides information on blood flow direction?
Which echocardiography technique provides information on blood flow direction?
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In echocardiography, which view provides an assessment of the left ventricle?
In echocardiography, which view provides an assessment of the left ventricle?
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What is critical to ensure successful ultrasound-guided techniques?
What is critical to ensure successful ultrasound-guided techniques?
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What type of information is primarily provided by the echogenicity of tissues in an ultrasound?
What type of information is primarily provided by the echogenicity of tissues in an ultrasound?
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What is an appropriate preparation step before an abdominal ultrasound?
What is an appropriate preparation step before an abdominal ultrasound?
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In echocardiography, which area is typically clipped for examination?
In echocardiography, which area is typically clipped for examination?
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Which structure is assessed using the right parasternal long axis view in echocardiography?
Which structure is assessed using the right parasternal long axis view in echocardiography?
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What does POCUS stand for in abdominal ultrasound practice?
What does POCUS stand for in abdominal ultrasound practice?
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Study Notes
Basic Ultrasonography
- Ultrasound uses sound waves to create images of internal structures.
- A current is applied to piezo-electric crystals within a transducer.
- This causes the crystals to vibrate, emitting sound waves.
- Sound waves reflect off tissues and organs, returning to the transducer.
- The returning waves generate an electrical signal.
- The signal is amplified and displayed as an image.
Interactions with Tissues
- Reflection: Sound waves reflect off tissues (echoes).
- Refraction: Sound waves change direction due to differing tissue velocities.
- Diffraction: Sound waves change direction through openings or around barriers.
- Attenuation: Loss of sound wave energy through scatter and absorption.
Ultrasound Probes
- Linear Array: Crystals in a line, producing rectangular images with a large footprint and no near-field artifact.
- Curved Array: Crystals in a curve, producing fan-shaped images with some near-field artifact and a smaller footprint.
- Phased Array: Crystals in a line, offering greater depth with fan-shaped images and smaller footprints. These probes can electronically steer the beam.
Frequency
- High Frequency: Better axial resolution, more rapid beam attenuation, poorer penetration.
- Low Frequency: Poorer axial resolution, less rapid beam attenuation, better penetration.
- Axial resolution is the ability to determine two points along the path of the beam.
Depth
- Sound waves from deeper structures are weaker due to attenuation.
- Time Gain Compensation (TGC) controls brightness levels at different depths.
Focus / Focal Zone
- Area of optimal image quality, often marked by a triangle.
- Focusing improves lateral resolution.
- Lateral resolution is the ability to determine two points perpendicular to the beam
- A narrow beam results in better lateral resolution
Ultrasound Artifacts
- Reverberation: Parallel bright lines caused by multiple reflections of sound waves.
- Mirror Image: Artifact at a curved reflective surface, appearing as a mirrored image.
- Acoustic Enhancement: Bright areas deep to fluid or air pockets caused by reduced attenuation.
- Poor Probe Contact: Artifact due to inadequate coupling gel.
- Acoustic Shadowing: Distal shadowing caused by highly reflective structures.
- Edge Shadowing: Acoustic shadow distal to a lateral aspect of cystic structures.
- Slice Thickness: Artifact, where the beam is wider than the cystic structure, mimicking a tissue interface.
Echogenicity
- Isoechoic: Structures with the same shade of gray as surrounding tissue.
- Hypoechoic: Structures with a darker shade of grey than surrounding tissue.
- Hyperechoic: Structures with a lighter shade of grey than surrounding tissue.
- Anechoic: Structures that appear black.
Echotexture
- Homogeneous: Uniform distribution of grey shades or dot sizes within the structure.
- Heterogeneous: Non-uniform distribution of grey shades or dot sizes within the structure.
Describing a Lesion
- Location, echotexture, measurements, outline, number, size (LEMONS).
- Echogenicity, echotexture and artifacts
Abdominal Ultrasound
- Indications (Elective): Any condition involving an abdominal organ, tumor identification/description, staging of neoplasia, intra-abdominal biopsy, reproductive tract investigations.
- Indications (Emergency): POCUS (point-of-care ultrasound) to identify free fluid (often post-trauma)
- Scanning areas: diaphragmatic hepatic (DH), hepato-renal (HR), spleno-renal (SR), cysto-colic (CC).
Benefits of Abdominal Ultrasound
- Non-invasive and safe.
- No general anesthesia required.
- Excellent morphological information and resolution.
- Comprehensive information from all major organs.
- Real-time sampling of tissues possible.
- Relatively inexpensive.
Disadvantages of Abdominal Ultrasound
- Limited functional information.
- Difficulty detecting diffuse disease.
- Sampling may be necessary for disease classification.
- Patient clipping is required.
- Sedation may be necessary.
- Gas interferes with sound transmission.
- Technically demanding to acquire high-quality images.
- Images might not be immediately interpretable by specialists.
Patient Preparation for Abdominal Ultrasound
- Withhold food (ideally 8 hours), drink is allowed.
- Clip the fur of the patient.
- Wash the patient to remove stray hairs.
- Apply liberal amounts of coupling gel.
- Sedation as required.
- Patient should be placed in lateral recumbency.
Patient Preparation (General)
- Allow plenty of examination time
- Use a darkened, quiet room
- Ensure the table is at the correct height
- Providing a vet bed or similar to patient to ensure comfort.
- Sufficient nursing support
Scanning Areas
- Systematic approach is crucial.
- Right lateral recumbency is often used to assess the left side; left lateral recumbency the right side.
- List of organs easily assessed in each position.
Ultrasound Guided Techniques
- Abdominocentesis, Cystocentesis (sample collection)
- Fine Needle Aspiration (FNA), Trucut biopsy, liver/spleen biopsy for histology.
- Preparing the skin aseptically, applying spirit to skin, protecting probe in glove with coupling gel.
Echocardiography
- Indications: Heart murmurs, ECG abnormalities, radiography abnormalities, hypertension, dyspnoea, syncope, arterial thromboembolism and pre-breeding screening.
Patient Preparation for Echocardiography
- Clip the fur over the heart region.
- Patient in lateral recumbency.
- Placement of the ultrasound probe onto the thorax: the probe is angled into the space between the 3rd-6th or 5th-7th intercostal space depending on the side of the heart
Echocardiography: Standard Views
- Right parasternal long-axis view
- Right parasternal short-axis view (Chordae tendineae, Papillary muscles, Mitral valve, Aortic valve)
- Subcostal view
- Left apical 4- and 5-chamber views
Thoracic Ultrasound
- General view: Normal lung with smooth hyperechoic line.
- Ribs: Hyperechoic line with a distal acoustic shadow.
TFAST
- 5-point assessment: Chest tube insertion site (x2), pericardium (x2), diaphragmatic/hepatic region.
- Uses: Evaluate for pleural space and pericardial effusion in trauma cases.
- Fluid = hypoechoic; absence of the 'glide sign' suggests air.
Vet BLUE assessment
- 4-areas: Caudodorsal, middle, perihilar, and cranial lung lobes.
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Description
Test your knowledge on the principles and techniques of ultrasonography. This quiz covers key concepts such as sound wave interactions, ultrasound probes, and image generation. Perfect for students and professionals in the medical field.
