ultra sound imaging general presentation
DESCRIPTION
It is simply a tutorial for medical studentsTRANSCRIPT
![Page 1: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/1.jpg)
Ultra sound imaging
A routine imaging modality
![Page 2: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/2.jpg)
Why U/S is day to day imaging modality?
Quick Cheap compare to other imaging Strict patient prep. not required Patient position is flexible Bedside imaging possible Repeat/ review possible No radiation hazard
![Page 3: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/3.jpg)
Ultrasound in emergency
It is focused in YES or NO question
eg. Is there ruptured entopic?
Is there cardiac tamponade?
Is there abdominal aortic aneurysm?
etc. etc.
![Page 4: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/4.jpg)
Indication in emergency
Trauma Cardiac Bleeding in pregnancy Acute abdominal pain Torsion of testis
![Page 5: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/5.jpg)
Trauma
Focussed abdominal sonography for trauma……….FAST
![Page 6: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/6.jpg)
What is FAST?
Detection of free intra abdominal fluid in blunt abdominal trauma
Quite reliable and sensitive
![Page 7: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/7.jpg)
FAST IN 4 views
Check fluid in_ 1. Morrison’s pouch
2.Perisplenic view
3.Pelvic view
(rectovesical/ cul de sac__ less than 250ml. fluid is detectable)
4.Pericardium
![Page 8: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/8.jpg)
Cardiac
To detect cardiac activity if pulse less electrical activity
To detect pericardial effusion
if yes, Is patient in cardiac tamponade?
( thumping on right cardiac chamber)
![Page 9: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/9.jpg)
Bleeding in pregnancy
Whatever is the gestational period
It could be_ ectopic pregnancy
threatened abortion
placenta praevia
any other
![Page 10: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/10.jpg)
Acute abdominal colic/pain
Few eg._ acute cholelithiasis
acute choledocholithiasis
acute pancreatitis
acute nephrolithiasis
acute torsion of ovary
ruptured aortic aneurysm
![Page 11: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/11.jpg)
Torsion of testes
Use of Doppler to assess vascular supply
![Page 12: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/12.jpg)
U/S is not diagnostic for
Intestinal obstruction Perforation
Plain X-ray supine/ erect or lateral decubitus is the first line of imaging modality
![Page 13: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/13.jpg)
Indications other than emergency
Abdominal Cardiac Vascular Pelvic
![Page 14: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/14.jpg)
Contd.
Eye Neck Breast Neonatal head/ brain Any other in consultation with clinician
![Page 15: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/15.jpg)
Abdominal problems
Ascitis_ to know the underlying cause
hepatic - chr. liver disease
renal - renal failure
cardiac - cardiac failure
extra pulmonary tubercular
malignancy
![Page 16: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/16.jpg)
Contd.
Jaundice_ Is it?
extrahepatic or intrahepatic
and then
to see the cause for it
![Page 17: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/17.jpg)
Mass in abdomen
To assess the size, shape and texture Origin of mass Extent of mass Adjoining vessels/ viscera Associated lesion( ascitis/ pl.effusion/ PE)
![Page 18: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/18.jpg)
Fever of unknown origion
Sub clinical/ occult malignancy Abdominal tuberculosis HIV ( immunosuppression) related
complication eg. abscess
![Page 19: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/19.jpg)
Cardiac problem
All cardiac lesion (except conduction defect or arrhythmia)
like_ cardio-megaly on X-ray chest
valvular lesion
congenital defects
![Page 20: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/20.jpg)
Vascular problem
Any pulsatile swelling- aneurysm Arterial thrombus Deep vein thrombosis Varicosity Peripheral vessel disease( limited help)
![Page 21: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/21.jpg)
Pelvic problems
Gynaecological_
infertility
bleeding disorder
mass in pelvic cavity
pelvic pain
lost IUCD
![Page 22: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/22.jpg)
Trans/endo vaginal scanning
Pregnancy less than 6 wks. Ectopic pregnancy Post menopausal bleeding Follicular study
![Page 23: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/23.jpg)
Obstetric ultrasound
To ascertain pregnancy_
size/ gestational age
site( IU/ ectopic)
viability( cardiac activity )
number
position/ lie
![Page 24: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/24.jpg)
Contd.
Placental localization Amniotic fluid ( normal AFI- 10) Umbilical cord Any congenital anomaly
![Page 25: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/25.jpg)
Doppler U/S in Obs.
To assess IUGR
( though the specificity is low ) Fetal distress
Commonly umbilical, middle cerebral, uterine artery are examined for systolic/ diastolic peak to assess RI/ PI
![Page 26: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/26.jpg)
Eye problem
Proptosis Trauma/ foreign body Retinal detachment/ tear/ haemorrhage Vitrous haemorrhage/ collapse
![Page 27: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/27.jpg)
Contd.
Ocular mass Cataract Retrobulbar mass Optic nerve( gross lesion ) Whenever funduscopy is inconclusive
![Page 28: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/28.jpg)
Neck problem
Enlarged thyroid Submandibular swelling Cervical lymphadenopathy Carotid artery plaque/ thrombosis(doppler)
![Page 29: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/29.jpg)
Breast problem
Enlarged breast eg. Fibrocystic disease Mass in breast Bleeding from nipple U/S guided FNAC or cyst aspiration
![Page 30: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/30.jpg)
Neonatal head/ brain
Enlarged head- ? hydrocephalus Neonatal fits- hypoxia
haemorrhage Congenital anomaly Birth trauma- ? subdural hematoma
![Page 31: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/31.jpg)
Last but not least
Any problem in consultation with clinician where ultrasound can help directly or by way of exclusion.
![Page 32: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/32.jpg)
Eur.J.emergency.Med 2009 Jul4 Epub
Imaging studies performed by technologist and then reviewed by radiologist with no patient contact are better quality studies.
This para digm of imaging misses the point of clinicians performed U/S
Clinician performed sonography in emergency has better accuracy
![Page 33: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/33.jpg)
Request from clinicians
Accurate clinical picture is really helpful for correct interpretation of U/S image
![Page 34: Ultra sound imaging general presentation](https://reader035.vdocument.in/reader035/viewer/2022062300/55654d2bd8b42a9b4c8b4ee0/html5/thumbnails/34.jpg)
Recent advances in U/S imaging
Despite developments other imaging techniques, the role of U/S continues to expand.
Its unrivalled ability to show events in the body in real time with continuing technological advances will