Sirpa Falk MCR EMEA BL US December 29, 2011 Routine exams Abdomen, Small parts, Msk & Vascular
Oct 19, 2014
Sirpa FalkMCR EMEA BL USDecember 29, 2011
Routine examsAbdomen, Small parts, Msk & Vascular
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Introduction to UltrasoundAbdominal Imaging - Anatomy
• The abdominal exam generally includes the examination of the following:
– Liver– Gallbladder– Right and Left Kidneys– Spleen– Pancreas– Aorta– IVC (inferior vena cava)
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Philips C5-1
• C5-1 / C9-4
– Wide far-field of view
– Wider near field than phased
– Supports multiple modalities
• S5-1
– When greater penetration is needed
Philips C9-4
Introduction to UltrasoundAbdominal Imaging – Transducers
Philips S5-1
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Introduction to UltrasoundAbdominal Imaging - Anatomy
• Liver
– Located inferior to the right 7th and 11th ribs
– Changes position with inspiration
Right Lobe
Left Lobe
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• Diffuse liver disease
–Cirrhosis (a condition in which the liver becomes scarred and fibrous, thus reducing its ability to function
–Fatty Liver disease
–In the United States, chronic alcoholism and hepatitis C are the most common causes.
Introduction to UltrasoundAbdominal Imaging - Anatomy
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Introduction to UltrasoundAbdominal Imaging - Anatomy
• Liver transplant evaluations
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• Liver Disease:
– Benign and malignant neoplasms
– Metastatic disease
– Liver abscess
Introduction to UltrasoundAbdominal Imaging - Anatomy
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Liver: Normal and abnormal blood flow.
• Portal Veins– Shows a monophasic flow pattern– Flows continuously in to the liver– Direction of flow is termed hepatopedal– With traditional color flow orientation, it should be encoded red
• Hepatic vein– Traditional color flow orientation is encoded blue
• Hepatic artery– Might be mistaken for the CBD
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• Liver Vasculature
– Hepatic veins
– Hepatic artery
– Portal Vein
Portal Vein
Introduction to UltrasoundAbdominal Imaging - Anatomy
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• Gallbladder and Bile Ducts
– Most common reason for gallbladder disease is gallstones
– Gallstones are solid stones formed in the gall bladder from cholesterol and bile salts
Introduction to UltrasoundAbdominal Imaging - Anatomy
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• Kidneys
Introduction to UltrasoundAbdominal Imaging - Anatomy
Long axis or sagittal view
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Transverse view
Introduction to UltrasoundAbdominal Imaging - Anatomy
• Kidneys
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Philips HD11 XE Ultrasound System
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Introduction to UltrasoundAbdominal Imaging - Anatomy
• Pancreas
– Pancreatitis
– Pancreatic carcinoma
– Pseudocysts
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Spleen: Physiology
• Large mass of lymphatic tissue• Not essential for life• Filters
– Blood– From Antibodies
• Breakdown hemoglobin• Reservoir for blood• Blood formation for fetuses and severe anemia.
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CHaSpa
Ca
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Introduction to UltrasoundSmall Parts Overview
• Imaging of:
– breasts, thyroid and testicles
• Performed to:– Assess lumps or other abnormalities– Guide interventional procedures
• Use linear transducer– High frequency– Increased resolution
Philips L12-5
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Introduction to UltrasoundSmall Parts Overview - Thyroid Scanning Demonstration
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Introduction to UltrasoundSmall Parts Overview
• Which transducer?• linear transducer
• Why?– High frequency– Increased resolution
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Introduction to UltrasoundSmall Parts Overview – Thyroid Anatomy
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An ultrasound of the thyroid is typically used to help diagnose:
・ a lump in the thyroid (Goiter, benign or malignant mass/nodule )
・ a thyroid that is not functioning properly
Introduction to UltrasoundSmall Parts Overview – Thyroid Imaging
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Ilium
Osseous Acetabular
IschiumTriradiateCartilage
Echogenic Labrum
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First
Second
Third
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Philips HD11 XE Ultrasound System
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Introduction to UltrasoundVascular Overview
• Provides imaging of the body's veins and arteries.
• Useful in evaluating the body's circulatory system
• Vascular ultrasound is performed to:
– assess blood flow to organs and tissues
– identify blockages (stenosis) and other abnormalities like blood clots,
plaque or emboli
– determine whether a patient is a good candidate for a procedure
such as angioplasty
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Introduction to UltrasoundVascular Overview -Anatomy
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Introduction to UltrasoundVascular Overview – Carotid
• Carotid Artery
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• Carotid Arteries:
– Assess patients with stroke, dizziness
– Flow patterns in the vessels (shape, speed & direction)
– Blood clot, dissection, narrowing of vessels, plaque
– Assess intima-media vessel layer thickness, an indicator of
cardiovascular disease
Introduction to UltrasoundVascular Overview - Carotid
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Introduction to UltrasoundVascular Overview – Carotid
Philips L9-3 (work-horse vascular transducer)
Which Transducer?Linear transducer (L9-3, L11-3
or similar)Why?
High FrequencyBetter detail resolutionLinear beam ideal for imaging
tubes
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• Which Transducer?– Sector transducer (S5-1 or similar)
• Why?– Good access to scanning windows available– Good frequency range for penetration
Introduction to UltrasoundVascular Overview - TCD
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TranstemporalWindow
Transoccipital/SuboccipitalWindow
TransorbitalWindow
Introduction to UltrasoundVascular Overview – TCD windows
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Introduction to UltrasoundVascular Overview - TCD
Global Training and Education Internal and Confidential30
Trans-cranial Artery Anatomy
MCA
ACA
VERTEBRAL
BASILAR
PCA
PCoA
ACoA
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• What are we looking for?– Flow patterns in the
vessels– Shape, speed and
direction of flow– Assessing patients with
strokes and cerebral bleeding
Introduction to UltrasoundVascular Overview - TCD