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Ultrasound
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Medical ultrasonography (sonography) is an ultrasound-based diagnostic
imaging technique used to visualize muscles and internal organs,
their size, structures and possible pathologies or lesions. Obstetric
sonography is commonly used during pregnancy and is widely recognized
by the public. There are a plethora of diagnostic and therapeutic
applications practiced in medicine.
In physics the term "ultrasound" applies
to all acoustic energy with a frequency above human hearing (20,000
hertz or 20 kilohertz). Typical diagnostic sonographic scanners
operate in the frequency range of 2 to 18 megahertz, hundreds
of times greater than this limit. The choice of frequency is a
trade-off between spatial resolution of the image and imaging
depth: lower frequencies produce less resolution but image deeper
into the body.
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Sonography (ultrasonography) is widely used in medicine. It is
possible to perform diagnosis or therapeutic procedures with the
guidance of sonography (for instance biopsies or drainage of fluid
collections). Sonographers are medical professionals who perform
scans for diagnostic purposes. Sonographers typically use a hand-held
probe (called a transducer) that is placed directly on and moved
over the patient. A water-based gel is used to couple the ultrasound
between the transducer and patient.
Sonography is effective for imaging soft tissues
of the body. Superficial structures such as muscles, tendons,
testes, breast and the neonatal brain are imaged at a higher frequency
(7-18 MHz), which provides better axial and lateral resolution.
Deeper structures such as liver and kidney are imaged at a lower
frequency 1-6 MHz with lower axial and lateral resolution but
greater penetration.
Medical sonography is used in, for example:
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Cardiology
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Endocrinology
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Gastroenterology
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Gynaecology; see gynecologic
ultrasonography
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Obstetrics; see obstetric
ultrasonography
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Ophthalmology; see A-scan
ultrasonography, B-scan ultrasonography
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Urology, to determine, for
example, the amount of fluid retained in a patient's bladder.
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Musculoskeletal, tendons,
muscles, and nerves
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Vascular, arteries and veins
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Intravascular ultrasound (e.g.
ultrasound guided fluid aspiration, fine needle aspiration,
guided injections)
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Intervenional; biopsy, emptying
fluids, intrauterine transfusion (Hemolytic disease of the newborn)
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Contrast-enhanced ultrasound
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A general-purpose sonographic
machine may be able to be used for most imaging purposes. Usually
specialty applications may be served only by use of a specialty
transducer. The dynamic nature of many studies generally requires
specialized features in a sonographic machine for it to be effective;
such as endovaginal, endorectal, or transesophageal transducers.
Sonograph showing the image of a fetal head in
the wombObstetrical ultrasound is commonly used during pregnancy
to check on the development of the fetus.
In a pelvic sonogram, organs of the pelvic region
are imaged. This includes the uterus and ovaries or urinary bladder.
Men are sometimes given a pelvic sonogram to check on the health
of their bladder and prostate. There are two methods of performing
a pelvic sonography - externally or internally. The internal pelvic
sonogram is performed either transvaginally (in a woman) or transrectally
(in a man). Sonographic imaging of the pelvic floor can produce
important diagnostic information regarding the precise relationship
of abnormal structures with other pelvic organs and it represents
a useful hint to treat patients with symptoms related to pelvic
prolapse, double incontinence and obstructed defecation
[1]
In abdominal sonography, the solid organs of the
abdomen such as the pancreas, aorta, inferior vena cava, liver,
gall bladder, bile ducts, kidneys, and spleen are imaged. Sound
waves are blocked by gas in the bowel, therefore there are limited
diagnostic capabilities in this area. The appendix can sometimes
be seen when inflamed eg: appendicitis.
Therapeutic Applications
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Therapeutic applications use
ultrasound to bring heat or agitation into the body. Therefore
much higher energies are used than in diagnostic ultrasound.
In many cases the range of frequencies used are also very different.
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Ultrasound may be used to
clean teeth in dental hygiene.
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Ultrasound sources may be
used to generate regional heating in biological tissue, e.g.
in occupational therapy, physical therapy and cancer treatment.
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Focused ultrasound may be
used to generate highly localized heating to treat cysts and
tumors (benign or malignant), This is known as Focused Ultrasound
Surgery (FUS) or High Intensity Focused Ultrasound (HIFU).
These procedures generally use lower frequencies than medical
diagnostic ultrasound (from 250 kHz to 2000 kHz), but significantly
higher energies. HIFU treatment is often guided by MRI.
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Focused ultrasound may be
used to break up kidney stones by lithotripsy.
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Ultrasound may be used for
cataract treatment by phacoemulsification.
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Additional physiological
effects of low-intensity ultrasound have recently been discovered,
e.g. its ability to stimulate bone-growth and its potential
to disrupt the blood-brain barrier for drug delivery.
[1] Bushberg JT (2002).
The essential physics of medical imaging. Lippincott Williams
& Wilkins. ISBN 0-683-30118-7.
Sonography of the female pelvic
floor Clinical indications and techniques
Content Reference (Wikipedia):
Medical ultrasonography
(last visited Nov. 25, 2007).
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