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Radiology > Ultrasound > Flashcards

Ultrasound Flashcards

1
Q

Which tissue or substance has the lowest and what highest velocity of sound

A

Air has lowest (331 m/sec), fat second lowest

Bone has highest (4080), lens of eye second highest

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2
Q

What are the 4 display modes

A

A mode
B mode
M mode
Doppler

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3
Q

A mode

A

Transducer sends a single pulse of ultrasound into medium, 1D image is created
- Good for ultrasound of eye

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4
Q

B mode

A

Can be viewed as 2D on screen, we can adjust the brightness to distinguish between tissues, find lesions easier etc

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5
Q

M mode

A

Pulses are emitted in quick succession, mostly used in cardiology, probe is not moving

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6
Q

Doppler

A

Probe finds the movement of blood.
Color “blue” when blood moves away from transducer (frequency is decreased)

Color “red” when blood moves toward the transducer (frequency is increased)

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7
Q

Curved array probe

A

Used less and less
More in equine medicine to find joints, muscles and tendons
Penetrates very deep

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8
Q

Convex probe

A

Smaller sensor investigative area
Fits between ribs
Mostly used in small animal ultrasound

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9
Q

Linear array

A

Flat sensor area
Maximum depth 10-13cm
Good for finding adrenal glands, pancreas

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10
Q

Pros of ultrasound examination

A

Not invasive
Can examine static organs
Anesthesia not required
Can be useful for FNA and biopsy

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11
Q

Cons of ultrasound examination

A

Machine is expensive
Due to artefacts, many wrong diagnoses
Can not examine bones
Not definitive

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12
Q

Scanning levels on ultrasound

A

Sagittal and parasagittal
Transversal
Oblique

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13
Q

Echogenicity

A

Ability to produce an echo

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14
Q

Anechogenic

A

Tissues producing no echo - appear black on image (fluid)

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15
Q

Hypoechogenic

A

Tissues producing few echoes, appear grey on image
liver, renal medulla, intestine, muscle

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16
Q

Hyperechogenic

A

Tissues producing strong echoes, appear bright on screen
Bone, air, stones

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17
Q

Noise artefacts

A

Small amplitude echoes
- like “static” in image
- Due to electrical interference
More likely to affect low-level hypoechoic regions rather than bright echogenic areas

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18
Q

Acoustic shadowing artefact

A

Hypoechoic or anechoic region extending downward from highly attenuating structure
Sakkaa rakossa, bladder stones
Same colour as image background

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19
Q

Acoustic enhancement artefact

A

Hyperechoic region beneath tissues with abnormally low attenuation

Characteristic of fluid-filled structures such as cysts, the urinary bladder and the gallbladder.

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20
Q

Reverberation artefact

A

Multiple, equally spaced echoes caused by bouncing of sound wave between two strong reflectors positioned parallel to ultrasound beam

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21
Q

Ring-down artefact

A

Due to metal for example biopsy needle

Part of reverberation artefact

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22
Q

Comet tail artefact

A

Solid hyperechoic line directed downward
- Type of reverberation
Arise from resonance, vibration of small structures like gas bubbles when they get bombarded by sound pulse

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23
Q

Mirror image artefact

A

Sound reflects off a strong reflector (mirror) and is redirected toward a second structure

Seen when there is a highly reflective surface (e.g. diaphragm) in the path of the primary beam

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24
Q

Edge-shadowing artefact

A

Appears as a hypoechoic region extending down from edge of a curved reflector

Prevents display of true anatomic structure that are positioned within extended hypoechoic region

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25
Q

Slice-thickness / beam-width artefact

A

Related to dimension of beam that is perpendicular to imaging plane
- Fills in hollow structures such as cysts
- Also called “pseudo-sediment artefact”
>Can check by “shaking” bladder. Real
sediment will make snowglobe movement

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26
Q

Preparing patient for ultrasound examination

A

There should be good contact between probe and skin - without air
- Preferably clip the skin
- Wet the area with alcohol mixture
- Ultrasound gel should be used

27
Q

Positioning of patient for abdominal study

A

Preferably on the back, laterally if gas is disturbing

28
Q

Positioning of patient for cardiological study

A

Laterally

29
Q

Focus button

A

Focusing narrows ultrasound beam width to improve lateral resolution and sensitivity

30
Q

Gain button

A

Affects the amplification of returning echoes
If it’s too high:
- Signal is saturated, loss of contrast
If it’s too low:
- Image too dark, loss of contrast

31
Q

Depth button

A

Can help remove irrelevant structures underneath, and focus only on what we want

32
Q

Time-gain compensation button

A

Signal gain is increased as time passes from the emitted wave pulse.
It makes equally echogenic tissues look the same even if they are located in different depths.

33
Q

When to ultrasound GI tract

A

When animal presents with:
- Persistent or chronic vomiting
- Diarrhea
- Abdominal pain
- Abdominal mass
- Weight loss, anorexia
- Foreign body ingestion

34
Q

Stomach wall normal thickness for a dog

A

2-5mm

35
Q

Stomach wall normal thickness for a cat

A

1.7 - 3.6 mm

36
Q

When to perform ultrasound exam on pancreas

A

When animal presents with
- Anorexia
- Weight loss
- Vomiting/diarrhea
- Abdominal pain
- Abdominal mass
- Hypoglycemia
- Icterus

37
Q

Echogenicity of pancreas

A

Iso- to slightly hypoechoic to surrounding fat

  • Homogenous echotexture
38
Q

Pancreatitis in dogs

A

More often acute
More obvious ultrasound signs
Clinically striking

39
Q

Pancreatitis in cats

A

More often chronic
Vague clinical signs - have as a DIFF
Less obvious ultrasound signs
- pancreas might look even normal
- Nodular hyperplasia
Laboratory test: Feline PLI

40
Q

When to perform ultrasound examination on liver

A

When patient presents with
- Hepatomegaly
- Abdominal mass
- Icterus
- Ascites
- Unspecific GI-disease
- Fever of unknown origin
- Search for metastases
- FNA/biopsy

41
Q

If liver is small, what can we assume

A

Hepatic fibrosis
Cirrhosis
Diaphragmatic hernia
Portosystemic shunt

42
Q

What do we check on liver?

A

Size
Shape
- Straight broders, sharp edges
Echogenicity
- Homogeous, moderately echogenic
- Even, granular texture
Structure
- Portal vein, hepatic vein, hepatic artery
- Bile ducts (not visible)

43
Q

Echogenicity of liver

A

Less than spleen and falciform fat
Equally or as echogenic as renal cortex
Coarser structure than with spleen

44
Q

Gallbladder wall thickness in cat

A

ALWAYS < 1 mm

45
Q

Gallbladder wall thickness in dog

A

< 2-3 mm

46
Q

Indications for spleen ultrasound

A

When animal presents with
- Splenomegaly
- Abdominal mass
- Peritoneal effusion/hemoperitoneum
- Abdominal pain, sudden weakness,
- Collapse
- Trauma patient

47
Q

When to consider ultrasound examination on lower urinary tract specifically?

A

Dysuria/hematuria/Stranguria
Urinary tract infections
Abnormalities on urinalysis
Urinary incontinence
Suspicion of ectopic ureters
Post trauma bladder integrity
Caudal abdominal mass
Evaluating perianal/inguinal rupture or hernia
Cystocentesis urine sample collection

48
Q

Echogenicity of bladder

A

Anechoic content

Echogenic urine is normal after cystocentesis and cetheterization

49
Q

Is echogenic urine specific for urinary tract disease?

A

No

50
Q

Artifacts of bladder

A

Side-lobe (pseudosludge)
Grating-lobe

51
Q

How can proximal urethra be visualised as ?

A

As a tubular hypoechoic structure continuing caudal to trigone region of bladder, and extending to the level of the pubic bone

52
Q

Indications for kidney examination

A

To detect abnormal palpation findings
Explain laboratory abnormalities
Urination problems
X-ray abnormalities
- Altered shape, size, bad detail
- Post trauma
- Urolithiasis

53
Q

Echogenicity of kidneys

A

Thin echogenic capsule may be visible
Renal cortex is hypoechoic - granular in texture
Medulla is anechoic, divided into segments by echogenic diverticula and vessels
Isoechoic slightly hypoechoic relative to liver

54
Q

Indications for examination of adrenal glands

A

Differentiation of primary and secondary hyperadrenocorticism
To investigate dorsal/retroperitoneal abdominal masses
To investigate hypertension causes
To search for metastasis

55
Q

Echogenicity of adrenal gland

A

Medulla echogenic

Cortex isoechogenic or hypoechogenic

56
Q

Indications for examining prostate

A

Recurrent, chronic UTI
Hematuria
Dysuria
Dyschezia (dififculty defecating)
Prostatomegaly
Fever of unknown origin
Caudal abdominal pain
Orchitis
Hematospermia

57
Q

Echogenicity of prostate

A

Medium ehcogenicity, homogenous parenchyma

  • Fine/coarse echotexture
58
Q

Indications to examine testicles

A

Prostatic or urinary tract disease
Endocrine dysfunction
Testicular enlargement
Testicular mass
Testicular or scrotal pain
Investigation of cryptorchidism
Infertility work-up

59
Q

Indications for examining uterus and ovaries

A

Diagnosis of pregnancy
Fetal development, viability
Vaginal discharge
Ovarian dysfunction, derangement of normal estrus cycle
Abdominal masses or pain

60
Q

When can we rule out pregnancy? around what day?

A

Dog: 30-33 days after last breeding
(5-8 days after fertilisation + 23-25 days of embryo development)

Cat: 15-20 days after last breeding

61
Q

Indications for examination of eye

A

Cloudy eye
- Hyphema
- Corneal edema
- Uveitis
- Cataract
- Retinal detachment
Glaucoma
Intraocular and retrobulbar masses
Trauma

62
Q

What changes with lens can we see on ocular ultrasound?

A

Luxation
Cataract
Nuclear sclerosis
Congenital abnormalities
RUpture

63
Q
A

Radiology (6 decks)

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