Ultrasound probe (curvilinear type) is used for examination of superficial structures.
Abdominal ultrasonography (also called abdominal ultrasound imaging or abdominal sonography) is a form of medical ultrasonography (medical application of ultrasound technology) to visualise abdominalanatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall (with the help of gel, which helps transmission of the sound waves). For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs.
Abdominal ultrasound is commonly used in the setting of abdominal pain or an acute abdomen (sudden and/or severe abdominal pain syndrome in which surgical intervention might be necessary), in which it can diagnose appendicitis or cholecystitis.
It can be used on the abdominal aorta to detect or exclude abdominal aortic aneurysm. For this purpose, the standard aortic measurement for abdominal aortic aneurysm is between the outer margins of the aortic wall.[4]
In cases of infectious mononucleosis, splenomegaly is a common symptom, and health care providers may consider using abdominal ultrasonography to get insight into a person's condition.[5] However, because spleen size varies greatly, ultrasonography is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports.[5]
Ultrasonography of the liver with some standard measurements[6]
In patients with deranged liver function tests, ultrasound may show increased liver size (hepatomegaly), increased reflectiveness (which might, for example, indicate cholestasis), gallbladder or bile duct diseases, or a tumor in the liver.
Ultrasonography of liver tumors involves two stages: detection and characterization.[citation needed] Tumor detection is based on the performance of the method and should include morphometric information (three axes dimensions, volume) and topographic information (number, location specifying liver segment and lobe/lobes). The specification of these data is important for staging liver tumors and prognosis.[citation needed] Tumor characterization is a complex process based on a sum of criteria leading towards tumor nature definition. Often, other diagnostic procedures, especially interventional ones, are no longer necessary. Tumor characterization using the ultrasound method will be based on the following elements: consistency (solid, liquid, mixed), echogenicity, structure appearance (homogeneous or heterogeneous), delineation from adjacent liver parenchyma (capsular, imprecise), elasticity, posterior acoustic enhancement effect, the relation with neighboring organs or structures (displacement, invasion), vasculature (presence and characteristics on Doppler ultrasonography and contrast-enhanced ultrasound (CEUS).[citation needed]
Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound.[7]
Technique
Advantages of ultrasound imaging of abdominal structures are that the procedure can be performed quickly, bed-side, involves no exposure to X-rays (which makes it useful in pregnant patients, for example) and is inexpensive compared to other often-used techniques such as computed tomography (CT scan) of the abdomen. Disadvantages are troublesome imaging if a lot of gas is present inside the bowels, if there is a lot of abdominal fat, and that the quality of the imaging depends on the experience of the person performing it.[citation needed]
The imaging occurs real-time and without sedation, so that the influence of movements can be assessed quickly. For example, by pressing the ultrasound probe against the gallbladder, a radiological Murphy's sign can be elicited.
Through the abdominal wall, organs inside the pelvis can be seen, such as the urinary bladder or the ovaries and uterus in women. Because water is an excellent conductor for ultrasound waves, visualizing these structures often requires a well-filled urinary bladder (this means the patients has to drink plenty of water before the examination).
The liver can be imaged by swiping the probe sagittally from medial to lateral at the subcoastal region. However, if majority of the liver parenchyma is located high up in behind the ribs, the subject can be asked to breathe deeply to push down the liver into the abdomen for better visibility of liver. If the liver is still not visualised, then the subject can be rolled to the left lateral position to move the liver out of the ribs. Then, the ultrasound probe is rotated 90 degrees to access the liver in axial plane from the dome of the diaphragm until the lower segment of the liver.[8]
Liver: Diffusely homogeneous and normal in echogenicity. No focal mass or contour nodularity. No intrahepatic biliary ductal dilatation. Portal Vein: Patent main portal vein. Gallbladder: No stones, wall thickening, or pericholecystic fluid. Common Bile Duct: Nondilated measuring 1.3 mm at the level of the porta hepatis. Pancreas: Visualized portions unremarkable. Spleen: Normal in size. Kidneys: Right and left kidneys measure 11.5 cm and 12 cm in length respectively. No hydronephrosis. Small left lower pole kidney cyst. Ascites: None. Aorta: Visualized portions normal in caliber, 16 x 15 mm. IVC: Normal.
Putukian M, O'Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, et al. (July 2008). "Mononucleosis and athletic participation: an evidence-based subject review". Clinical Journal of Sport Medicine. 18 (4): 309–315. doi:10.1097/JSM.0b013e31817e34f8. PMID18614881. S2CID23780443.
Spielmann AL, DeLong DM, Kliewer MA (January 2005). "Sonographic evaluation of spleen size in tall healthy athletes". AJR. American Journal of Roentgenology. 184 (1): 45–49. doi:10.2214/ajr.184.1.01840045. PMID15615949.
