Ch. 6: Basic Ultrasound Imaging: Techniques, Terminology, and Tips Flashcards
Role of Sonographer
- To differentiate (1) ____ ____ from (2) ____ ____
- Cells make up (3) ____
- When we are scanning an organ, we are looking for (4) ____ ____ so we must know what is normal
- Document and discuss those findings with a (5) ____
- But we do not (6) ____— we describe what we (7) ____ with a sonographic description of the pathology
- We only describe what we see sonographically
- normal tissue
- abnormal tissue
- tissues
- abnormal tissue
- radiologist
- diagnose
- see
Sonographic Terms
- We use terms to describe things (1) ____ and (2) ____ of an organ or vessel
- The (3) ____ of an organ can be described as (4) ____– uniform and (5) ____ shades of gray and (6) ____- parenchyma is described as (7) ____ shades of gray
- [Parenchyma: (8) ____ ]
- Functional tissue of an organ can be described as either (9) ____ or (the opposite) heterogenous
- All the echos that are being reflected back from the transducer to display on the ultrasound screen can be the same (10) ____ or have different (11) ____
- Echos represent (12) ____ and (13) ____
- within
- outside
- parenchyma
- homogenous
- same
- heterogenous
- different
- Functional tissue
- homogenous
- strengths
- strengths
- tissues
- pathologies
Physics
- Frequency (1) ____ ____(mHz)
- Lower frequency transducer = (2) ____ resolution but deeper (3) ____
- E.G. kidney, liver (4) ____ mHz
- Higher frequency transducer produce (5) ____ attenuation meaning absorbed by tissue = less (6) ____
- Higher (7) ____ = (8) ____ resolution
- E.G. Muscles, tendons (9) ____ mHz
- Low frequency transducers are used for (10) ____ ____
- High frequency transducers are used for (11) ____ parts/ (12) ____ structures
- 1-18 megahertz
- less
- penetration
- 1-6
- more
- penetration
- frequency
- higher
- 7-18
- abdominal scanning
- small
- superficial
Abdominal Ultrasound Uses Curvilinear Probe
- Large (1) ____ ____
- Low (2) ____
- Increased (3) ____
- foot print
- frequency
- depth
Echoes Reflected Back to Transducer
- Echogenicity – A method of describing the (1) ____ ____
- How we describe what is being (2) ____ ____
- What is strong or weak?
- Hypoechoic – (3) ____ ( ____ reflection)
- Hyperechoic – (4) ____ ( ____ reflection)
- Anechoic – (5) _____ ( ____ echos)
- Seen when scanning (6) ____, ____, or ____
- No (7) ____
- Isoechoic – (8) ____
- Echos being reflected back from an organ with the (9) ____/____ echo
- reflecting echos
- reflected back
- Darker (less)
- Brighter (more)
- Black (no)
- fluids, cysts, or vessels
- tissues
- Equal
- same/similar
Ultrasound Appearance of Tissues
- Veins– (1) ____, ____
- Arteries– (2) ____, ____
- Fat– (3) ____ with irregular (4) ____ ____
- Muscle– (5) ____, Separated w/ (6) ____ ____
- Tendon– (7) ____ & (8) ____ like
- Ligaments– Like (9) ____, but more (10) ____
- Bone– (11) ____ ____ with a (12) ____
- Nerves– (13) ____ ____ appearance: (14) ____
- Arteries are thick
- Veins are thinner
- Both arteries and vein do not have an ultrasound reflection
- They are both anechoic because sound waves will continue to travel through a cystic/fluid filled structure
- There is nothing to bounce back from
- In cystic structures, blood vessels, and cysts, sound waves do not bounce back
- Anechoic, Compressible
- Anechoic, Pulsatile
- Hypoechoic
- hyperechoic lines
- Hypoechoic
- hyperechoic septa
- Hyperechoic
- Fiber
- tendons
- compact
- Hyperechoic lines
- shadow
- Starry night
- Transverse
Criteria for Identifying Abnormalities
- Border: (1) ____ and ____, or ____
- Texture: (2) ____ or ____
- All the echos within a mass will either be different or the same
- Characteristic: (3) ____, ____, ____, ____ or ____, as compared with the rest of the parenchyma
- Compare the mass to whatever organ is being scanned
- Transmission of sound: (4) ____, ____ or ____
- Example: An anechoic mass (fluid-filled cyst) will show increased transmission of sound, whereas a dermoid tumor (composed of muscle, teeth, bone) will show decreased transmission
- Smooth and well-defined, or irregular
- Homogeneous or heterogeneous
- Anechoic, hypoechoic, isoechoic, hyperechoic, or echogenic
- Increased, decreased, or unchanged
The abnormality is identified and evaluated according to a number of criteria which include the: ____ ____, ____ ____, ____ ____, and ____ ____ ____
border definition, internal texture, tissue characteristics, and transmission of sound
Abnormal Structures That Affect Transmission
- Cyst: Has (1) ____, _____, well-defined (2) ____ borders and is (3) ____
- (4) ____ through-transmission
- Complex: Has characteristics of both a (5) ____ and a (6) ____ structure
- Solid: Has (7) ____ borders and (8) ____ echoes
- (9) ____ through-transmission
- Abscess: May have (10) ____ borders and debris within; transmission may or may not be (11) ____
- Homogenous mass: Has a (12) ____ texture within
- Heterogenous mass: Has a (13) ____ texture within
- Infiltrating mass: Has a (14) ____ architecture, (15) ____ borders, and (16) ____ transmission
- smooth, round
- thin
- anechoic
- Increased
- cyst
- solid
- irregular
- internal
- Decreased
- irregular
- increased
- uniform
- nonuniform
- distorted
- irregular
- decreased
Anechoic or Sonolucent
- Opposite of (1) ____
- Without (2) ____ ____
- The structure is (3) ____ filled and transmits sound (4) ____
- Examples: (5) ____, ____, ____, and ____
- echogenic
- internal echoes
- fluid
- easily
- Vascular structures, distended urinary bladder, gallbladder, and amniotic cavity
Echogenic or Hyperchoic
- Opposite of (1) ____
- (2) ____-producing structure
- Reflects sound with a (3) ____ intensity
- Examples: (4) ____, ____, ____, ____, ____, and ____
- anechoic
- Echo
- brighter
- Gallstone, renal calyx, bone, fat, fissures, and ligaments
Hypoechoic
- (1) ____-level echoes within a structure
- Examples: (2) ____ and ____
- Low
- Lymph nodes and fibroma
Isoechoic
- (1) ____ close to the normal parenchyma echogenicity pattern
- Example: (2) ____ ____
- Very
- Metastatic disease
Homogenous
- Opposite of (1) ____
- Completely (2) ____ in texture or composition
- Example: ____, ____, ____
- heterogeneous
- uniform
- The textures of the liver, thyroid, testes, and myometrium are generally considered homogeneous
Heterogeneous
- Not uniform in (1) ____ or ____
- Example: (2) ____
- texture or composition
- Many tumors have characteristics of both decreased and increased echogenicity
Enhancement, Increased through-transmission
- Sound that travels through an (1) ____ (fluid-filled) substance and is not attenuated
- Brightness is increased directly beyond the (2) ____ ____ of the anechoic structure as compared with the surrounding area—this is “enhancement”
- anechoic
- posterior border
Shadowing
- The sound beam is attenuated by a (1) ____ or ____ object
- This (2) ____ or ____ may be partial or complete
- Air bubbles in the (3) ____ may cause a “dirty shadow” to occur secondary to reflection
- A stone would cause a sharp shadow (4) ____ to its border
- solid or calcified
- reflection or absorption
- duodenum
- posterior
Infiltrating
- Usually refers to a (1) ____ ____ process or (2) ____ disease
- Examples: (3) ____ or ____
- diffuse disease
- metastatic
- Carcinoid or sarcoid infiltration
Irregular Borders
- Borders are not (1) ____ ____, are ill defined, or are not present
- Examples: (2) ____, ____, and ____
- well defined
- Abscess, thrombus, and metastases
Artifacts
- Can be good or bad
- Produced and caused by sonographers due to wrong incorrect procedure or from machine
- (1)
- (2)
- (3)
- (4)
- (5)
- Reverberation
- Mirror
- Side lobe
- Distal enhancement (Good artifact)
- Shadowing (Good artifact)
Anechoic, Sonolucent
Without internal echoes; The structure is fluid filled and transmit sound easily
Echogenic, Hyperechoic
Echo-producing structure; Reflects sound with a brighter intensity
Enhancement, Increased through transmission
Sound that travels through an anechoic (fluid-filled) substance and is not attenuated. There is increased brightness directly beyond the posterior border of the anechoic structure as compared with the surrounding area
Fluid-fluid level
Interface between two fluids with different acoustic characteristics. This level will change with patient position
Heterogenous
Not uniform in texture or composition
Homogenous
Completely uniform in texture or composition
Hypoechoic
Low-level echoes within a structure
Infiltrating
Usually refers to a diffuse disease process or metastatic disease
Irregular borders
Borders are not well-defined, ill-defined, or are not present
Isoechoic
Very close to the normal parenchymal echogenicity pattern
Loculated mass
Well-defined borders, with internal echoes; The septa may be thin (likely benign) or thick (likely malignant)
Shadowing
Sound beam is attenuated by a solid or calcified object
Shadowing
Sound beam is attenuated by a solid or calcified object
Anechoic, Sonolucent (Example)
Vascular structures, distended urinary bladder, gallbladder, and amniotic cavity
Echogenic, Hyperechoic (Example)
Gallstone, renal calyx, bone, fat, fissures, and ligaments
Heterogenous (Example)
Many tumors have characteristics of both decreased and increased echogenicity
Homogenous (Example)
The textures of the liver, thyroid, testes, and myometrium (generally)
Hypoechoic (Example)
Lymph nodes and fibroma
Infiltrating (Example)
Carcinoid or sarcoid infiltration
Irregular borders (Example)
Abscess, thrombus, and metastases
Isoechoic (Example)
Metastatic disease
Description of the abnormal structure: Simple cyst
Has smooth, round, well-defined thin borders and is anechoic, Increased through-transmission
Description of the abnormal structure: Complex/Complicated cyst
Has characteristics of both a cyst and a solid structure
Description of the abnormal structure: Solid
Has irregular borders and internal echoes, Decreased through-transmission
Description of the abnormal structure: Abscess
May have irregular borders and debris within; transmission may or may not be increased
Description of the abnormal structure: Homogenous mass
Has a uniform texture within
Description of the abnormal structure: Heterogenous mass
Has a nonuniform texture within
Description of the abnormal structure: Infiltrating mass
Has a distorted architecture, irregular borders, and decreased transmission
Ultrasound appearance of the tissue: Veins
Anechoic, Compressible
Ultrasound appearance of the tissue: Arteries
Anechoic, Pulsatile
Ultrasound appearance of the tissue: Fat
Hypoechoic with irregular hyperechoic lines
Ultrasound appearance of the tissue: Muscle
Hypoechoic, Separated w/ hyperechoic septa
Ultrasound appearance of the tissue: Tendon
Hyperechoic & Fiber like
Ultrasound appearance of the tissue: Ligaments
Like tendons, but more compact
Ultrasound appearance of the tissue: Bone
Hyperechoic lines with a shadow
Ultrasound appearance of the tissue: Nerves
Starry night appearance: Transverse
