ABDOMINAL ECHOGRAPHY

Echography is an excellent initial investigation for most abdominal problems.

Even such gastro-intestinal problems as hypertrophic pyloric stenosis can perfectly be diagnosed in a child with the help of ultrasonography.

 

 "Hypertrophic pyloric stenosis in a child"

Most liver disorders are diagnosed promptly with the help of echography. Here is a common example:

Irregular (granular) liver surface in a cyrrhotic liver with ascites.

 

Calculous cholecystitis (cholelithiasis): mobile gall stones in the inflamed gall bladder

INDICATIONS:

The most common indications for abdominal real-time echography include the following:

1. Evaluation of gall bladder disorders.
2. Detection of biliary obstruction.
3. Evaluation of the liver and any masses in it.
4. Evaluation of the pancreas.
5. Screening for an abdominal aortic aneurysm.
6. Evaluation and characterization of suspected abdominal disorders, e.g. peri-appendiceal abscess, peri-colonic abscess, ascites, haemoperitoneum, mesothelioma, and other conditions   associated with ill-feeling, weight loss or fever of unknown origin.
7. Echographic guidance of aspiration and needle biopsy procedures. 

Other indications for echography are:
Retroperitoneal masses that may mimic masses that arise within the abdomen. However, in general, real-time echography is not as accurate as computed tomography for evaluation of the retroperitoneum.  

RENAL AND UROGENITAL ECHOGRAPHY
Echography is very helpful in diagnostic evaluation of the kidneys, adrenals, urinary bladder, scrotum and prostate gland.

 

 "Renal stones in the upper and lower poles of the kidney without dilatation"

 

 "Stone in the renal pelvis with moderate dilatation"

 

 "Stone in the renal pelvis transverse with dilatation"

 
Real-time renal echography allows more consistent and detailed delineation of the kidneys when compared to static imaging techniques, and can be helpful in the evaluation and detection of the following renal and urogenital conditions:

1. Renal calculous disease.
2. Renal cystic masses (renal polycystosis).
3. Solid renal masses.
4. Poorly functioning kidneys (obstructive v/s parenchymal disease).
5. Malformations of kidneys.
6. Ectopic position of kidneys.
7. Perirenal and intrarenal abscesses.
8. Guidance during biopsy, cyst aspiration and percutaneous antegrade nephrostomy procedures.
9. Renal transplant evaluation: (a) perirenal transplant masses; (b) rejection.
10. Adrenal masses.
11. Scrotal disorders: (a) epididymitis; (b) neoplasm; (c) abscess; (d) testicular torsion.
12. Prostate disease: (a) lesion identification and confirmation; (b) biopsy guidance.
13. Bladder neoplasm.

 

 "Splenomegaly"

 

 "Lipoma in the subcutaneous tissue"

 

 "Benign hypo-echoic thin-walled cyst of the female breast"

ECHOGRAPHY OF THE HEART AND BLOOD VESSELS
Echocardiography is a diagnostic technique that uses ultrasound waves to produce images of the heart and study the latter's structures and functions. Depending on the type of echocardiography test used, doctors can learn about the size, shape and movements of different structures of the heart, such as itsmuscular walls, inter-atrial septum, interventricular septum, valves and blood flow. Echocardiography can also give doctors information about your coronary arteries.

 

 "Mid-muscular ventricular septal defect of the heart"

How does it function?

Echocardiography uses high-frequency ultrasound waves that can provide a moving picture of your heart. The sound waves are sent through the body with a device called a transducer. The sound waves bounce off the heart and return to the transducer as echoes. The echoes are converted into images of the heart that can be visualized on a monitor.

• One-dimensional or M-mode echocardiography is one beam of ultrasound directed towards the heart. Doctors most often use M-mode echocardiography to see just the left side (or main pumping chamber) of your heart.
• Two-dimensional echocardiography produces a broader moving picture of your heart. Two-dimensional echocardiography is one of the most important diagnostic tools for doctors.
• Doppler echocardiography measures blood flowing through the arteries and shows the pattern of flow through the heart.

 

 "Doppler Ultrasound Color Echocardiography"

 
No special preparation is needed for an echocardiography.

During the test, you will lie on an examination couch. A technician will place small metal disks called electrodes on your chest. These electrodes have wires called leads, which hook up to an electrocardiogram machine. This machine will monitor your heart rhythm during the test.

Next, the technician will put a thick gel on your chest. The gel may feel cold, but it does not harm your skin. Then, the technician will use the transducer to send and receive the sound waves.

The transducer will be placed directly on the left side of your chest, above your heart. The technician will press firmly as he or she moves the transducer across your chest. You may be asked to breathe in or out or to briefly hold your breath during the test. But, for most of the test, you will lie still.

An echocardiogram may take up to 45 minutes to perform. You should not have any pain or discomfort during the test.

As an imaging technology for visualizing the heart and great vessels, ultrasonography has a number of very significant advantages:

1. Ultrasonography has virtually negligible biologic effect as it uses acoustic waves for its imaging mechanism; therefore, echographic imaging can be repeated at frequent intervals on the same patient, making it an excellent means of monitoring.
2. Cardiac images show excellent contrast at the endocardial-blood boundary and valve structures as blood is hypo-echogenic compared to tissue.
3. Using different imaging windows between the ribs of the chest,sequential multiple planar views are obtainable, permitting visualization of virtually all portions of the myocardium at real-time imaging rates (greater than 30 images per second).
4. Doppler assessment of local blood velocities using a sample position guided by the two-dimensional image or whole image color-encoded Doppler imaging permits accurate characterization of the direction and pattern of blood flow. The combination of structural and flow information allowed by the technology offers nearly complete definition of a variety of cardiac anomalies.