Ultrasounds

What is Ultrasound?
Ultrasound imaging, sometimes called sonography is a method of obtaining images from inside the human body by using high frequency sound waves. As sound passes through the body, echoes are produces that identify how far away an object is, the size of the object, its shape and consistency (solid, fluid or mixed). Ultrasound can also measure the flow of blood using a specialized method called Doppler ultrasound. No radiation is used with ultrasound imaging. Ultrasound is a useful way of examining many of the body’s internal organs such as the liver, gallbladder, spleen, pancreas, kidneys, bladder, uterus, ovaries, thyroid and testicles.

When is ultrasound used?
Many expectant parents have first seen their unborn child with an ultrasound exam. Ultrasound is used extensively for evaluating pelvic and abdominal organs, blood vessels, and can help a physician determine the source of pain, swelling or infection in many parts of the body. Because ultrasound provides real-time images, it is also useful as a guide for needle biopsies. Ultrasound is also used to evaluate superficial structures such as the breast, thyroid and testicles.

Doppler ultrasound is a special technique used to examine blood flow. Doppler images can help to determine blockages of blood flow (such as a blood clot) and build up of plaque inside a blood vessel.

How should I prepare for the procedure?
If possible, you should wear loose, comfortable clothing for your exam. Each exam can require a different prep. Click below on the exam you are having for specific instructions.

Venous Ultrasound

(also called Venous Dopplers)
What are the common uses of this procedure?
A venous ultrasound is used to evaluate the veins in the body, particularly in the legs and arms. It is common to use ultrasound to evaluate the veins for a blood clot, especially in the legs. When a blood clot develops in the vein, ultrasound can show the clot and also the slowing or complete blockage of blood flow that is causes.

How should I prepare for the procedure?
You should dress comfortably, but you may have to remove clothing and jewelry depending on the exam. There is no special preparation needed for a venous ultrasound.

What can I expect during the procedure?
You will be asked to lie on your back on the exam table. The technologist will use gel and press the transducer against your skin. The technologist will take images of your veins and also listen to your veins with Doppler ultrasound. Venous ultrasounds are usually painless, however if your leg is swollen and tender, the pressure from the transducer may add to your discomfort. The exam will last approximately 30 minutes.
Ultrasound Guided Breast Cyst Aspiration

What are some common uses of the procedure?
Some women develop cysts or fluid filled sacs in their breasts. These cysts can be diagnosed with ultrasound and are typically simple and benign. Most cysts do not need to be aspirated.

Occasionally, a cyst will become very large and painful or not look completely simple on ultrasound and need to be drained or aspirated. Ultrasound can be used to locate a cyst in the breast that needs to be aspirated.

How should I prepare for the procedure?
There is no preparation for a breast cyst aspiration.

What can I expect during the procedure?
You will be asked to put on a gown. You will need to lie on your back or slightly rolled to your side during the aspiration.

A radiologist – a physician trained to diagnose conditions by interpreting medical images – will perform the aspiration. The radiologist will explain the procedure before he or she begins.

The radiologist uses lidocaine to numb the area to be aspirated. This can sometimes sting for a few seconds but that quickly goes away. After the numbing you may feel some pressure or pushing but you should not feel anything sharp for the remainder of the procedure.

The radiologist uses the ultrasound probe to locate the cyst in the breast and guides a small needle into the area to draw out the fluid.

The radiologist will look at the fluid and determine whether or not to send it to the lab to be evaluated.

After the radiologist is finished we will put a band-aid over the spot where the needle was inserted.

You can expect to be at Advanced Medical Imaging for approximately 30 minutes. The aspiration will only take about five minutes.
Carotid Ultrasound

(also called Carotid Dopplers)
What are the common uses of this procedure?
Imaging of the carotid is most commonly used to detect narrowing, or stenosis, of the carotid artery. If your doctor finds a carotid bruit (an abnormal sound in the neck heard with a stethoscope) an ultrasound may be needed.

How should I prepare for the procedure?
Wear a loose fitting, open necked shirt or blouse for this ultrasound. You may be asked to remove any jewelry or objects around your neck. No special preparation is need for a carotid ultrasound.

What can I expect during the procedure?
You will be asked to lie on your back on the exam table. The technologist will use gel and press a transducer against your neck. The transducer is pressed against the skin on both sides of the neck from the collarbone region to the jaw line. The procedure is painless and noninvasive. You will hear pulse-like sounds as the procedure is being done. The exam will take approximately 45 minutes.
Ultrasound Guided Breast Biopsy

What are some of the common uses of the procedure?

In most cases, it is not possible to tell from a mammogram or breast ultrasound whether a growth is benign or malignant. Ultrasound guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound.

How should I prepare for the procedure?
You may eat lightly before the biopsy.

You must not be taking aspirin, aspirin containing products or blood thinners for seven days prior to a needle biopsy.

You will be able drive after the procedure.

What can I expect during the procedure?
You will be asked to remove clothing from the waist up and put on a gown. You will lie on your back or slightly on your side on the ultrasound table for your biopsy.

A radiologist – a physician trained to diagnose conditions by interpreting medical images – will perform the biopsy. The radiologist will explain the procedure before he or she begins the biopsy.

The radiologist uses lidocaine to numb the area that is to be biopsied. This can sometimes sting for a few seconds but that quickly goes away. After the numbing you may feel pressure or pushing but you should not feel anything sharp for the remainder of the procedure.

The radiologist uses the ultrasound probe to locate the lesion and guides a biopsy needle to the mass to be biopsied. He or she will usually take about five to seven samples of the area using a spring-loaded device. Each sample will make a “snapping” noise but it should not hurt.

After the radiologist takes the samples, a nurse or technologist will apply pressure to the site to minimize any bleeding. They will put a gauze dressing over the biopsy site and give you an ice pack. You will be sent home with a list of simple instructions.

You can expect to be at Advanced Medical Imaging for approximately 45 minutes. The actual biopsy will take about 15 to 20 minutes.

How do I get the results of my biopsy?
The samples that we take are sent to a laboratory to be evaluated. It takes approximately two working days for the pathologist to look at the sample and make a diagnosis.

The results are faxed to your referring physician who should contact you regarding the diagnosis.
Ultrasound Guided Fine Needle Aspiration of Thyroid

(sometimes called a thyroid biopsy)

What are some of the common uses of the procedure?
It is not possible to tell from imaging tests whether a growth in the thyroid is benign or malignant. Ultrasound guided fine needle aspiration of the thyroid is a way to evaluate nodules within the thyroid that are visible on ultrasound.

How should I prepare for the procedure?
You may eat lightly before the procedure.

You should not be taking any aspirin, aspirin containing products or blood thinners for seven days prior to a fine needle aspiration.

You will be able to drive after the procedure.

What can I expect during the procedure?
You will be asked to put on a gown. You will need to lie on your back with your neck extended during the procedure.

A radiologist – a physician trained to diagnose conditions by interpreting medical images – will perform the aspiration. The radiologist will explain the procedure before he or she begins the aspiration.

The radiologist uses lidocaine to numb up the area in the neck that is to be sampled. This can sometimes sting for a few seconds but that quickly goes away. After the numbing you may feel some pressure of pushing but you should not feel anything sharp for the remainder of the procedure.

The radiologist uses the ultrasound probe to locate the lesion in the thyroid and guides a tiny needle into the area to draw out cells. He or she will usually take about four samples. The cells are put on slides and also put into a special solution to be sent to the lab evaluated.

After the radiologist is finished, a nurse or technologist will hold pressure over the area sampled in the neck. They will put a small band-aid over the biopsy site and give you an ice pack and some simple instructions to follow at home.

You can expect to be at Advanced Medical Imaging for approximately 45 minutes. The fine needle aspiration will take about 20 minutes.

How do I get the results of my biopsy?
The samples that are taken are sent to a laboratory to be evaluated. It takes approximately two working days for the pathologist to look and sample and make a diagnosis.

The results are faxed to you referring physician who should contact you regarding the diagnosis.
Thyroid Ultrasound

What are the common uses of this procedure?

A thyroid ultrasound evaluates both lobes of the thyroid and the isthmus of the thyroid. It also evaluates the neck for any abnormal appearing lymph nodes.

Your physician may order this test if there is a lump in your neck or if you have other symptoms of thyroid disease (such as weight loss/gain, abnormal blood work etc…). An ultrasound can show masses within the thyroid or measure the size of the thyroid to determine if it is enlarged.

How should I prepare for the procedure?
Wear a loose fitting, open necked shirt or blouse for this ultrasound. Avoid wearing turtleneck shirts if possible. If the neckline of your shirt is too high you may be asked to change into a gown. You may be asked to remove any jewelry or other objects around your neck. There is no special preparation needed for a thyroid ultrasound.

What can I expect during the procedure?
You will be asked to lie on your back on an examination table. A pillow will be placed under your shoulders so that your neck will be extended allowing the technologist access to your thyroid. The technologist will use gel and apply a transducer to the neck. The transducer will be moved around to obtain different views of the thyroid and neck. The exam will take less than 30 minutes.
Breast Ultrasound

What are the common uses of this procedure?

Breast ultrasound is used when a patient has had a recent abnormal mammogram that shows a change from prior years or if a patient has a new palpable lump in their breast. If you are under age 35 and you have a symptom such as a lump in your breast, your doctor may order an ultrasound of your breast before a mammogram because the tissue in a younger person’s breast can be hard to penetrate with a mammogram.

An ultrasound is very good at finding cysts (fluid filled sacs) in the breast. Sometimes it also finds solid lesions in the breast.

How should I prepare for the procedure?
There is no preparation for a breast ultrasound.

What can I expect during the procedure?
You will be asked to remove clothing from the waist up and put on a gown. You will have to lie on your back on the examination table. The technologist will use gel and apply a transducer to the breast. The transducer will be moved around to obtain different views of the area of interest in the breast. The exam will take less than 30 minutes.
Obstetrical Ultrasound

What are the commons uses of this procedure?

Obstetrical ultrasound is used to evaluate an embryo or fetus. This ultrasound can estimate the age of the pregnancy, diagnose congenital abnormalities, evaluate the fetal and placental location and determine if there are multiple pregnancies. Conventional ultrasound displays the images as thin sections (like looking at single slices of bread in a loaf.) Ultrasound can watch the heart beat and movement of the fetus like an ongoing movie.

How should I prepare for the procedure?
You should wear a loose fitting two-piece outfit for the examination, which allows for easy access to the lower abdomen.

You will need to have a full bladder for this examination. You should drink 4-6 glasses of water before your exam. In order for the water to have time to get to your bladder, you should be finished drinking one hour prior to your exam time. Do not empty your bladder before your exam.

What can I expect during the procedure?

If you are less than 14 weeks along:
You will be asked to lie on your back on the exam table with your bladder full. The technologist will use gel and press a transducer against the pelvis. The transducer will be swept back and forth across the pelvis to image the areas of interest.

Most early OB ultrasounds require a transvaginal ultrasound. This is performed by inserting a probe into the vagina – similar to having a pelvic exam at your physician’s office.

Before the vaginal ultrasound, you will be asked to empty your bladder completely. You will also need to change into a gown. You will then be asked to lie on your back with your feet up in stirrups. The transvaginal probe is inserted into the vagina and images of the fetus, uterus and ovaries are obtained.

You may experience some discomfort while images are obtained with your bladder full. The transvaginal ultrasound should not be painful. It is usually more comfortable than a gynecological exam.

The entire exam should take approximately 30 minutes.

If you are more that 14 weeks:
You will be asked to lie on your back on the exam table with your bladder full. The technologist will use gel and press a transducer against the lower abdomen. The transducer will be swept back and for the across the pelvis to image the areas of interest. The technologist may have to push and angle the transducer in various positions to get accurate pictures of the fetus.

The exam should take approximately 45 minutes.

You will receive pictures of your baby to take home. We do not have the capability to video tape your exam.
Renal Ultrasound

(also called kidney or retroperitoneal ultrasound)

What are the common uses of this procedure?
A renal ultrasound is used to evaluate the kidneys, bladder, aorta and inferior vena cava.

It is common to use ultrasound to evaluate the anatomy of the kidneys and bladder looking for cysts or stones as well as to evaluate size and appearance. Your doctor may also order this test to evaluate your aorta for an aneurysm.

How should I prepare for the procedure?
You may eat lightly before this procedure. It helps to evaluate the bladder if there is something in it. Before you arrive, drink approximately 24oz of liquid one hour before your exam and try to avoid using the restroom during that time.

Wear comfortable, loose fitting clothing that can allow easier access to the abdomen (i.e., shirt and pants rather than a one piece dress).

What can I expect during the procedure?
You will be asked to lie on your back on the exam table. The technologist will use gel and press a transducer against the abdomen. The transducer will be swept back and forth across the abdomen to image the areas of interest. You may be asked to take in deep breaths and hold them. This will sometimes help bring the organs out from underneath ribs or bowel gas in order to see them better. You may be asked to roll onto your side in order to obtain better images. The exam will last approximately 30 minutes.
Abdomen Ultrasound

What are the common uses of this procedure?
Ultrasound of the abdomen is used to evaluate structures in the upper abdomen (above the umbilicus). Images are taken of the liver, kidneys, spleen, pancreas, gall bladder, common bile duct, aorta and inferior vena cava.

It is very common to use ultrasound to look for stones in the gall bladder or to evaluate size and structure of organs such as the liver and spleen.

How should I prepare for the procedure?
Ultrasound cannot penetrate bowel gas and food and drink can affect how the gall bladder looks. Therefore, it is important that you not have anything to eat or drink (including water) for 8 hours prior to the procedure. If you are on medication that you cannot go without, you may take it with a very small amount of water.

Wear comfortable, loose fitting clothing that can allow easier access to the abdomen (i.e shirt and pants rather than a one piece dress).

What can I expect during the procedure?
You will be asked to lie on your back on the exam table. The technologist will use gel and press a transducer against the abdomen. The transducer will be swept back and forth across the abdomen to image the areas of interest. You may be asked to take in deep breaths and hold them. This will sometimes help bring the organs out from underneath ribs or bowel gas in order to see them better. You also may be asked to roll onto your side. This helps to get better images and to evaluate the gall bladder. The exam will take approximately 30 minutes.

What does the equipment look like?
Ultrasound scanners consist of a console containing a computer, a video screen and a transducer that is used to scan the body. The transducer is a small, hand-held device that is attached to the console by a cord. The transducer is pressed against the area of interest to obtain images. These images appear immediately on a video screen. The technologist watches this screen continually during the exam and captures specific images for the radiologist to review.

What should I expect during my exam?
You will be expected to lie on your back on a comfortable exam table. Gel is applied to the patient’s body in the area to be examined. The gel assures that there is direct contact with the skin. The technologist presses the transducer firmly against the skin and sweeps it back and forth to obtain images of the area of interest. When the exam is complete you may be asked to wait in the room while the images are reviewed.

Most exams are painless, fast and easy. To obtain the appropriate images the technologist may have to apply some pressure, which may cause varying degrees of discomfort.

How do I get the results of my exam?
After the technologist has completed your exam, the images are reviewed by a radiologist – a physician specially trained to diagnose conditions by interpreting medical images. A written report is then faxed to your referring physician within 24 hours of completion of the exam. Once your physician receives and reviews the results of your exam, they will contact you to inform you of the results. You will not receive results at the time of your examination.

What are the benefits and risks of ultrasound?
Ultrasound has many benefits. It is noninvasive (does not use any needles or injections) and is usually painless. Ultrasound is easily available. It uses no ionizing radiation (x-ray), which makes it the preferred method to image pregnant women and their unborn children. Ultrasound can provide real-time imaging which makes it useful for guiding biopsy procedures.

There are no known harmful effects on humans.

What are the limitations of ultrasound?
Ultrasound does not penetrate bone. For visualization of bone, other imaging modalities, such as MRI may be used.

Ultrasound does not pass through air. Therefore, it is not useful in evaluating the organs that contain gas such as the stomach, small intestine or large intestine. Intestinal gas may also prevent visualization of deeper structures such as the pancreas and aorta. Patients suffering from obesity are more difficult to image because extra tissue weakens the sound waves as they pass deeper into the body.

Advanced Medical Imaging

Ultrasounds