Electrotherapy lecture

1. Ultrasound

2. Ultrasound
 Ultrasound is a scanning technique used to
image the growing fetus. The transducer
portion emits inaudible sound waves, which
fan out as they travel through your abdomen.
When they hit dense structures like the fetus
and the wall of your uterus, the sound waves
bounce back to the transducer and are
translated into a visual image by the computer.

3.  Ultrasound has been used by radiologists and
sonographers to image the human body for at
least 50 years and has become a widely used
diagnostic tool. The technology is relatively
inexpensive and portable, especially when
compared with other techniques, such as
magnetic resonance imaging (MRI) and
computed tomography (CT).
 Sonography does not use ionizing radiation,
and the power levels used for imaging are too
low to cause adverse heating or pressure
effects in tissue

4.  Alternative Names Sonogram
 This practice parameter was revised
collaboratively by
 The American College of Radiology (ACR),
 The Society for Pediatric Radiology (SPR),
and The Society of Radiologists in Ultrasound
(SRU).

5. What happens during an
ultrasound scan?
 Most ultrasound scans don’t take long to
perform, typically between 15 and 45 minutes.
Your ultrasound scan will generally take place
in an X-ray department in hospital and be
performed either by a doctor, who will provide
a diagnostic report, or by a sonographer.
 A sonographer is a specialist trained in the use
of ultrasound, who will provide a descriptive
report for the doctor to make a diagnosis.S

6. Preparing for an ultrasound scan
 Before having some types of ultrasound scan, you
may be asked to follow certain instructions before
the procedure, such as:
 Drink water and not go to the toilet until after the
test – this is to fill your bladder and may be needed
before a scan of your unborn baby or your pelvic
area
 Avoid eating for several hours before the scan –
this may be needed before a scan of your abdomen
to lower the amount of air and gas in your
stomach or bowel and enable your gallbladder to
be better assessed

7.  There are different kinds of ultrasound scans
depending on which part of the body is being
scanned and why. The three main types are:
 External ultrasound
 Internal ultrasound
 Endoscopic ultrasound

8. External Ultrasound
 An external ultrasound scan is most often used
to examine your heart or an unborn baby in
your womb.
 It is also used to examine the liver, kidneys
and other organs in the abdomen and pelvis.

9. Internal Ultrasound
 An internal examination allows looking more
closely inside the body at organs such as the
prostate gland, ovaries or womb.
 You will be asked to either lie on your back or
on your side with your knees drawn up to your
chest. An ultrasound probe is placed into the
vagina or rectum and images are transmitted to
a screen.
 Internal examinations may cause some
discomfort but do not usually cause any pain
and shouldn't take very long.

10. Endoscopic Ultrasound
 Endoscopic ultrasound is where a long, thin,
flexible tube (an endoscope) is inserted into
your body, usually through your mouth, to
examine areas such as your stomach,
esophagus or the lymph nodes in your chest.
 You will usually be asked to lie on your side
and swallow the endoscope, which is then
carefully pushed down towards your stomach.

11. How Ultrasound Imaging Works
 Ultrasound, also called sonography, uses
sound waves to develop ultrasound images of
what's going on inside the body. An instrument
called a transducer emits high-frequency
sound, inaudible to human ears, and then
records the echoes as the sound waves
bounce back to determine the size, shape, and
consistency of soft tissues and organs.

12.  This information is relayed in real time to
produce images on a computer screen.
Ultrasound technicians, or sonographers, have
special training in how to perform the test.
Then a radiologist or your doctor will interpret
the ultrasound images. This technology can
help diagnose and treat certain conditions.

13. Types of Ultrasound
 Most ultrasounds are done using a transducer
on the surface of the skin. Sometimes,
however, doctors and technicians can get a
better diagnostic image by inserting a special
transducer into one of the body's natural
openings:
 In a transvaginal ultrasound, a transducer
wand is placed in a woman’s vagina to get
images of her uterus and ovaries.

14.  A transrectal ultrasound is sometimes used in the
diagnosis of prostate conditions.
 A transesophageal echocardiogram uses the
transducer probe in the esophagus so that the
sonographer can obtain clearer images of the
heart.
 Additionally, ultrasound technology has advanced
to allow for different types of imaging:
 Doppler is a special type of ultrasound that
creates images of blood flow through vessels.
 Bone sonography helps doctors diagnose

15.  Echocardiograms are used to view the heart.
 3D imaging adds another dimension to the
ultrasound image, creating three-dimensional
interpretations rather than the flat two-
dimensional images that are made with
traditional ultrasound.
 4D ultrasounds

16. What are the prerequisites for
having an Ultrasound done?
 A concise, relevant clinical history, as this will
improve the efficacy of any diagnostic imaging
test.
 Relevant recent pathology or imaging results.

17. What are the absolute
contraindications for an Ultrasound?
 There are no absolute contraindications for an
ultrasound examination.

18. What are the relative contraindication
for an Ultrasound?
 There are no relative contraindications for an
ultrasound examination.

19. What are the adverse effects of
an Ultrasound?
 Your patient should not experience any
adverse effects from ultrasound examination.

20. Are there alternative imaging tests,
interventions or surgical procedures
to an Ultrasound?
 Ultrasound is generally considered a primary
diagnostic modality, because it is cheap, easily
accessible and is very accurate in many
settings. Be aware that patients with specific
indications may be better referred to CT and
MRI directly.

21. Ultrasound Comparison
 To demonstrate how an ultrasound works, imagine this tennis
ball as an internal organ in the body. Like many organs, the
tennis ball is solid on the outside and hollow on the inside. Solid
structures, such as bones and muscles, reflect sound waves
from the ultrasound transducer and show up as white in an
ultrasound image. Soft or hollow areas, like chambers of the
heart, do not reflect sound waves and appear as black. The
white ring is the outer edge of the tennis ball being reflected

22. Typical Appearance of Normal
tissue
 Skin appears smooth and bright
 Fat subcutaneous fat is typically dark.
 Muscle is also dark.
 Fluid, blood, effusion or cyst is generally black
,though thicker fluids such as puss can be
bright or dark.
 Tendons are typically bright, but this varies
with their orientation relative to the probe.

23.  Nerves are not normally seen when scanning
the shoulder, but their appearance is similar to
that of tendons.
 Bone appears as a particularly bright line
bright between bone and soft tissue.
 High frequency ultrasound does not penetrate
bone effectively and therefore the screen is
generally black deep to the bone.

24. Ultrasounds offer many advantages
 They are generally painless and do not require
needles, injections, or incisions.
 Patients aren't exposed to ionizing radiation,
making the procedure safer than diagnostic
techniques such as X-rays and CT scans. In
fact, there are no known harmful effects when
used as directed by your health care provider.
 Ultrasound captures images of soft tissues that
don't show up well on X-rays.

25.  Ultrasounds are widely accessible and less
expensive than other methods.
 By comparison with CT, MR, X-Ray and other
diagnostic methods, Ultrasound Diagnosis,
especially for soft tissues and moving organ like
heart and blood flow, has shown great advantages
as following:
 Real Time Imaging (Except MR)
 Real-time ultrasonography
 Rapid serial ultrasound images produced using a
phased array or scanning transducer; produces a
video display of organ motion, such as heart valve
or fetal motion.

26.  Non-invasive (Except MR)
 Non-ionizing Radiation (Except MR)
 Relatively Low Cost
 Wide Applications
 Mobility
 Flexible Imaging
 Biopsy

27.  The applications of diagnostic ultrasound
technology include, but are not limited to:
 Obstetrical and gynecological ultrasound.

28. Ultrasound in Pregnancy
The ultrasound has become a standard procedure used during pregnancy. It
can demonstrate fetal growth and can detect increasing numbers of
conditions in the fetus including meningomyelocele, congenital heart disease,
kidney abnormalities, hydrocephalus, anencephaly, club feet, and other
deformities. Ultrasound does not produce ionizing radiation and is considered
a very safe procedure for both the mother and the fetus.

29.  Thoracic, abdominal, and pelvic ultrasound.

30. Abdominal Ultrasound
Abdominal ultrasound is a scanning technique used to
image the interior of the abdomen. Ultrasound scans use
high frequency sound waves to produce an image and do
not expose the individual to radiation. The procedure is
painless and safe.

31.  Renal and retroperitoneal(back of the peritoneum)
ultrasound.

32.  Vascular ultrasound (carotid, abdominal,
intracranial, peripheral arterial and peripheral
venous studies, including pulsed, power, and
color Doppler).

33. Guidance of interventional
biopsy and therapeutic
procedures.

34. Intraoperative ultrasound.

35. Ophthalmologic Ultrasound

36.  Evaluation of superficial structures such as
breast, thyroid, testicle, skin.
 Endoluminal ultrasound.

37. Neurosonography.

38. Echocardiography.

39. Ultrasonic Densitometry
Musculoskeletal ultrasound