Saskatoon Medical Imaging/Saskatoon Women's Imaging
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Ultrasound uses high-frequency, inaudible, sound to create images. The ultrasound services provided include: Abdominal ultrasound Ultrasound imaging is based on the principles involved in the sonar used by bats, submarines, ships at sea, and anglers with fish finders. Sound is emitted by a transducer source, when this sound interacts with tissues and organs echoes are created. The echoes can be used to identify how far away the tissue or organ is, how large it is, its shape and its internal consistency (fluid, solid or mixed), and how uniform it is. The ultrasound transducer functions as both a loudspeaker (to create the sound) and a microphone (to record the returning echoes). When the ultrasound transducer is pressed against the skin, it directs a stream of inaudible, high-frequency sound into the body. As the sound waves echo from the body's fluids and tissues, the sensitive microphone in the transducer records the characteristics of the reflected sound. There are two major components of the ultrasound examination: a) returning sound waves are instantly measured and displayed by a computer, which in turn creates a video picture on the ultrasound monitor (real-time images); b) images frozen by the ultrasound machine and stored as representative images of the real-time findings. Both the real-time images and the frozen images of the examination can be recorded on videotape, on film, or on computer disk. Doppler ultrasonography is the application of diagnostic ultrasound to detect moving blood cells and measure their direction and speed of movement. The Doppler effect is used to evaluate blood flow by measuring changes in the frequency of the echoes reflected from blood cells. Most ultrasound devices also have an audio component that processes the echoes produced by blood flowing through the foetal heart, blood vessels and umbilical cord. This sound can be made audible to human ears and has been described by patients as a "whooshing noise." The real-time element of ultrasound allows for the detection of movement i.e. foetal movements, heart valve function, blood vessel pulsation. This component is an integral part of the examination and the technologist and the radiologist must be very familiar with what normal real-time functions of various organs and tissues are to complete a thorough assessment of each patient. Conventional ultrasound displays the images as thin sections (like looking at single slices of bread in a loaf). 3-D ultrasound is the result of modern computer technology, that can reformat data into three-dimensional images (like looking at the entire loaf of bread in various projections). 4-D ultrasound is 3-D ultrasound in motion. How should I prepare for the procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. Other preparation depends on the type of examination you will have. For some scans, your doctor may instruct you not to eat or drink for as many as 12 hours before your appointment. What does the ultrasound equipment look like? Ultrasound scanners consist of a console containing a computer, a keyboard, and electronics, a video display screen and the transducer that is used to scan the body. The most important part of the equipment consists of the transducer connected to the main machine by a long cord. The transducer is a small hand-held device that resembles a microphone. The radiologist or technologist will spread a lubricating gel on the area being examined and then press the ultrasound transducer firmly against the skin using the gel to augment sound transmission. The ultrasound image is immediately visible on a nearby screen that looks much like a computer or television monitor. The radiologist or sonographer watches this screen during an examination and captures representative images for storage. Often, the patient is able to see it as well. How is the procedure performed? The patient is positioned on an examination table, and a clear gel is applied to the area to be examined to augment the ultrasound transmission and reception. The sound waves produced by the transducer cannot penetrate air, so the gel helps to eliminate air pockets between the transducer and the skin. The technologist or radiologist then presses the transducer firmly against the skin and sweeps it back and forth to image the area of interest. Most modern ultrasound machines have a wide array of transducers. There are some that are designed for abdominal imaging, some for superficial structures, and there are some for use in the rectum and the vagina. The technologist and radiologist will determine when these special ultrasound probes are required and use them to best advantage, depending upon your clinical condition. For the most part, you will be asked to lie still, on your back, on the examination table and hold your breath from time-to-time to assist in acquisition of the best images. Sometimes patients are asked to roll to different positions but this will be at the discretion of the technologists and the radiologist involved. When the examination is complete, the patient may be asked to dress and wait while the ultrasound images are reviewed, either on film or on a monitor. Often, though, the sonographer or radiologist is able to review the ultrasound images in real time as they are acquired, and the patient can be released immediately. What will I experience during the procedure? Ultrasound imaging of the is painless, fast, and easy. You will lie on your back on an examining table. The radiologist or sonographer will spread some warm gel on your skin and then press the transducer firmly against your body, moving it until the desired images are captured. There may be varying degrees of discomfort from pressure as the radiologist or sonographer guides the transducer over your abdomen, especially if you are required to have a full bladder. For some procedures such as prostate ultrasound or transvaginal ultrasound the transducer is placed in the rectum or the vagina. This may be uncomfortable for some patients, however, the technologist will do their best to minimize the discomfort. Most ultrasound examinations take less than 30 minutes. What are the benefits vs. risks? Benefits
Risks
What are the limitations of Ultrasound Imaging? Ultrasound waves are reflected by air or gas; therefore ultrasound is not an ideal imaging technique for the bowel. Barium exams and CT scanning are the methods of choice for bowel-related problems in most cases. Ultrasound waves do not pass through air; therefore an evaluation of the stomach, small intestine and large intestine may be limited. Intestinal gas may also prevent visualization of deeper structures, such as the pancreas and aorta. Patients suffering from obesity are more difficult to image—this is because tissue attenuates (weakens) the sound waves as they pass deeper into the body. Ultrasound has difficulty penetrating bone and therefore can only see the outer surface of bony structures and not what lies within and beyond. For visualizing bone or internal structures of certain joints, waves do not reflect clearly from bone or air. For visualization of bone, other imaging modalities, such as MRI (magnetic resonance imaging), may be selected. What is Abdominal Ultrasound Imaging? Ultrasound imaging, also called ultrasound scanning or sonography, is a method of obtaining images of internal organs by sending high-frequency sound waves into the body. The reflected sound waves (echoes) are recorded and displayed as a real-time visual image. No ionizing radiation (x-ray) is involved in ultrasound imaging. An abdominal ultrasound image is a useful way of examining internal organs, including the liver, gallbladder, spleen, pancreas, kidneys, and bladder. Because ultrasound images are captured in real time, they can show movement of internal tissues and organs and enable physicians to see blood flow. This can help to diagnose a variety of conditions and to assess changes related to illness. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. How should I prepare for the Abdominal Ultrasound procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. If the clothing you have selected is not appropriate the technologists will give you a gown to wear. SMI Preparation for Abdominal Ultrasound a) Do not take anything to eat or drink for 8 - 10 hours prior to your appointment time except your regular medications with small amounts of water. What does the ultrasound equipment look like? Ultrasound scanners consist of a console containing a computer, a keyboard, and electronics, a video display screen and the transducer that is used to scan the body. The most important part of the equipment consists of the transducer connected to the main machine by a long cord. The transducer is a small hand-held device that resembles a microphone. The radiologist or technologist will spread a lubricating gel on the area being examined and then press the ultrasound transducer firmly against the skin using the gel to augment sound transmission. The ultrasound image is immediately visible on a nearby screen that looks much like a computer or television monitor. The radiologist or sonographer watches this screen during an examination and captures representative images for storage. Often, the patient is able to see it as well.
How is the procedure performed? The patient is positioned on an examination table, and a clear gel is applied to the area to be examined to augment the ultrasound transmission and reception. The sound waves produced by the transducer cannot penetrate air, so the gel helps to eliminate air pockets between the transducer and the skin. The technologist or radiologist then presses the transducer firmly against the skin and sweeps it back and forth to image the area of interest. Most modern ultrasound machines have a wide array of transducers. There are some that are designed for abdominal imaging, some for superficial structures, and there are some for use in the rectum and the vagina. The technologist and radiologist will determine when these special ultrasound probes are required and use them to best advantage, depending upon your clinical condition. For the most part, you will be asked to lie still, on your back, on the examination table and hold your breath from time-to-time to assist in acquisition of the best images. Sometimes patients are asked to roll to different positions but this will be at the discretion of the technologists and the radiologist involved. When the examination is complete, the patient may be asked to dress and wait while the ultrasound images are reviewed, either on film or on a monitor. Often, though, the sonographer or radiologist is able to review the ultrasound images in real time as they are acquired, and the patient can be released immediately. What will I experience during the procedure? Ultrasound imaging of the is painless, fast, and easy. You will lie on your back on an examining table. The radiologist or sonographer will spread some warm gel on your skin and then press the transducer firmly against your body, moving it until the desired images are captured. There may be varying degrees of discomfort from pressure as the radiologist or sonographer guides the transducer over your abdomen, especially if you are required to have a full bladder. For some procedures such as prostate ultrasound or transvaginal ultrasound the transducer is placed in the rectum or the vagina. This may be uncomfortable for some patients, however, the technologist will do their best to minimize the discomfort. Most ultrasound examinations take less than 30 minutes.
What are the current recommendations for abdominal ultrasound? Ultrasound imaging is used extensively for evaluating the kidneys, liver, gallbladder, pancreas, spleen, and blood vessels of the abdomen. Because it provides real-time images, it can also be used to:
Doppler ultrasound is a special type of ultrasound study that examines major blood vessels. These images can help the physician to see and evaluate:
What are the benefits vs. risks? Benefits
Risks
What are the limitations of Ultrasound Imaging? Ultrasound waves are reflected by air or gas; therefore ultrasound is not an ideal imaging technique for the bowel. Barium exams and CT scanning are the methods of choice for bowel-related problems in most cases. Ultrasound waves do not pass through air; therefore an evaluation of the stomach, small intestine and large intestine may be limited. Intestinal gas may also prevent visualization of deeper structures, such as the pancreas and aorta. Patients suffering from obesity are more difficult to image—this is because tissue attenuates (weakens) the sound waves as they pass deeper into the body. Ultrasound has difficulty penetrating bone and therefore can only see the outer surface of bony structures and not what lies within and beyond. For visualizing bone or internal structures of certain joints, waves do not reflect clearly from bone or air. For visualization of bone, other imaging modalities, such as MRI (magnetic resonance imaging), may be selected. Sample Images
What is Breast Ultrasound Imaging? Ultrasound imaging, also called ultrasound scanning or sonography, is a method of obtaining images of internal organs by sending high-frequency sound waves into the body. The reflected sound waves (echoes) are recorded and displayed as a real-time visual image. No ionizing radiation (x-ray) is involved in ultrasound imaging. An breast ultrasound image is a useful way of examining the internal structure of this organ. Because ultrasound imaging is able to take advantage of the doppler effect in moving blood it can assess blood flow in abnormalities of the breast. This information can help to diagnose a variety of conditions and to assess alterations caused by illness. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. What are some common uses of the procedure? Breast ultrasound is most often used to provide further information about the breast and axillary region when the mammogram suggests an area of concern. It is also often performed if the patient has a palpable nodule or mass, but this cannot be visualized on mammography for one reason or another. Breast ultrasound may be used in follow-up or as a primary imaging device for the breast tissue of young patients as there is concern about administering mammography radiation to the breast tissue at a young age. Ultrasound imaging of the breast may be indicated in the following circumstances: * In determining if a structure is cystic (fluid-filled) or solid. * Gain further information about a mammographic finding. * Assess a palpable breast abnormality not seen on mammography. * Guide procedures such as needle biopsies, in which needles are used to sample cells from for laboratory testing. * Help a physician determine the nature of painful or palpable lesions of the breast. Doppler ultrasound is a special type of ultrasound study that examines major blood vessels. These images can help the physician to see and evaluate: * For breast imaging, doppler ultrasound assists the physicians in determining if a solid or cystic structure is associated with any abnormal blood vessels or blood flow. With knowledge about the speed and volume of blood flow gained from an ultrasound image, the physician can often determine whether a patient will require further testing or biopsy procedures. How should I prepare for the procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. If the clothing you have selected is not appropriate the technologists will give you a gown to may be selected. Sample Images
What is Obstetric Ultrasound Imaging? Ultrasound imaging, also called ultrasound scanning or sonography, is a method of obtaining images of internal organs by sending high-frequency sound waves into the body. The sound wave echoes are recorded and displayed as a real-time visual image. No ionizing radiation (x-ray) is involved in ultrasound imaging. Obstetric ultrasound refers to the specialized use of sound waves to visualize and thus determine the condition of a pregnant woman and her embryo or foetus. For a more detailed description of the ultrasound modality please refer to the Ultrasound page.
How should I prepare for the procedure? You should wear a loose fitting two-piece outfit for the examination. Only the lower abdominal area needs to be exposed during this procedure; consequently, a two-piece outfit will prevent you from having to readjust or remove all of your clothing. If an ultrasound is required early in your pregnancy, you may be required to have a full bladder for the procedure. Air interferes with sound waves, so if your bladder is distended, the air-filled bowel is pushed out of the way and an image of the uterus and embryo or foetus is obtained. About an hour and a half before the procedure, you should empty your bladder. You may be instructed to drink up to six glasses of water and avoid urinating until the procedure is completed. A full bladder is not necessary in the later stages of pregnancy. The radiologist or sonographer may elect to examine an early pregnancy by means of transvaginal ultrasound. This requires an empty urinary bladder. You should ask for instructions when you make your appointment. SMI Obstetrical US Preparation a) Early (Up to 10 weeks) 2 hours before your appointment time, empty your bladder and then drink 4 large glasses of water. Do not empty your bladder again. b) Mid (10 - 20 weeks) 1 hour before your appointment time, empty your bladder and then drink 3 large glasses of water. Do not empty your bladder again. c) Late (after 20 weeks) 1 hour before your appointment time, empty your bladder and then drink 1 large glass of water. Do not empty your bladder again. What are some common uses of the procedure? Obstetric ultrasound should be performed only when clinically indicated. Some indications may be:
Sample Images
What is Ultrasound Imaging of the Musculoskeletal System? Ultrasound or sonography involves the sending of sound waves through the body. Those sound waves are reflected off the internal organs. The reflections are then interpreted by special instruments that subsequently create an image of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging. An ultrasound image is a useful way of examining the musculoskeletal system of the body to detect problems with muscles, tendons, ligaments, joints and soft tissue. Ultrasound images are captured in real time, so they can often show movement, function and anatomy, as well as enable radiologists to diagnose a variety of conditions and assess damage after an injury or illness. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. What are some common uses of the procedure? Ultrasound images can be useful in diagnosing tendon tears, such as tears of the rotator cuff in the shoulder or Achilles tendon in the ankle. Abnormalities of the muscles can also be seen, such as tears and soft-tissue masses. Bleeding or other fluid collections within the muscles, bursae and joints can also be detected. Ultrasound has not proven useful in detecting whiplash injuries or other causes of back pain. How should I prepare for the procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. No other preparation is required. Sample Images
What is Pelvic Ultrasound Imaging? Ultrasound or sonography involves the sending of sound waves into the body. Those sound waves are reflected off the internal organs. The reflections are then recorded by special instruments that subsequently create an image of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging. For women, pelvic ultrasound is most often used to examine the uterus and ovaries and, during pregnancy, to monitor the health and development of the embryo or fetus. In men, a pelvic ultrasound usually focuses on the bladder and the prostate gland. Ultrasound images are captured in real-time, so they can show movement of internal tissues and organs, such as the flow of blood in arteries and veins. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. How should I prepare for the procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. You will be asked to drink up to six glasses of water two hours prior to your exam, so that your bladder is full when the scan begins. A full bladder helps with visualization of the uterus, ovaries and bladder wall. For transvaginal examinations, no bladder filling is required. SMI Preparation for Pelvic Ultrasound 2 hours before your appointment time, empty your bladder and then drink 4 large glasses of water. Do not empty your bladder again. What are some common uses of the procedure? Millions of expectant parents have seen the first "picture" of their unborn child thanks to pelvic ultrasound examinations of the uterus and fetus (see the Obstetric Ultrasound page). However, monitoring of fetal development is not the only reason for a pelvic ultrasound exam. For women, ultrasound examinations can help determine the causes of pelvic pain, abnormal bleeding, or other menstrual problems. Ultrasound images can also help to identify palpable masses such as ovarian cysts and uterine fibroids, as well as ovarian or uterine cancers. Sonohysterography (saline infusion sonography) is a relatively new procedure in which sterile saline is injected into the uterus while a transvaginal sonogram is performed. The purpose is to distend the uterine cavity (endometrial cavity) to look for polyps, fibroids, or cancer, especially in patients with abnormal uterine bleeding. Other indications include evaluation of the uterine cavity looking for uterine anomalies (abnormal uterine shapes since birth) or scars. The saline outlines the lesion and allows for easy visualization and measurement. Some physicians also use sonohysterography for patients with infertility. Saline and air are injected into the uterus and the physician looks for air bubbles passing through the fallopian tubes, which would indicate patency of the fallopian tubes. In men, pelvic ultrasound is a valuable tool for evaluating the prostate gland, as well as for evaluating the seminal vesicles. Ultrasound is often used to perform imaging guided biopsy. A common biopsy in the pelvis involves a rectal ultrasound for detection of prostate cancer. A pelvic ultrasound exam can help to identify stones, tumors and other disorders in the urinary bladder in both men and women. Because ultrasound provides real time images, it can also be used to guide procedures, such as needle biopsies, in which a needle is used to sample cells from an abnormal area for laboratory testing. Doppler sonography is another method of ultrasound that can be used to evaluate blood flow in pelvic vessels. Sample Images
What is Scrotal Ultrasound Imaging? Ultrasound or sonography involves sending sound waves into the body. These sound waves are reflected off the internal organs and are recorded by special instruments that create images of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging. Ultrasound images are captured in real-time so they can show movement of internal tissues and organs, such as the flow of blood in arteries and veins. Ultrasound imaging of the scrotum is the primary imaging method used to evaluate disorders of the testicles and surrounding areas. It is used when a patient is experiencing pain or swelling in the scrotum, a mass has been felt by the patient or doctor, or there's been trauma to the scrotal area. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. How should I prepare for the procedure? Besides wearing comfortable, loose-fitting clothing, there is no preparation for an ultrasound exam of the scrotum. What are some common uses of the procedure? For males, ultrasound is a valuable tool for evaluating the testes, the epididymis (a tube that collects sperm made by the testicles) and the prostate. Scrotal ultrasound imaging can help determine the cause of testicular pain or swelling. Some of the problems ultrasound imaging can identify include: inflammation of the scrotum, an absent or undescended testicle, testicular torsion, abnormal blood vessels or a lump or tumor. A sudden onset of pain in the scrotum is very serious. The most common cause of scrotal pain is epididymitis, an inflammation of the epididymis. It is treatable with antibiotics. Left untreated, this condition can lead to an abscess or loss of blood to the testicles. Ultrasound can detect an absent or undescended testicle as well. In rare cases a testicle may fail to develop. More often, patients have an undescended testicle. It is estimated that approximately three percent of baby boys have undescended testicles. It's important to diagnose an undescended testicle because it has a very high probability of developing cancer if left untreated. Ultrasound can identify testicular torsion, the twisting of the spermatic cord that contains the vessels that supply blood to the scrotum. Caused by abnormally loose attachments of tissues that are formed during fetal development, torsion commonly appears during adolescence and is very painful. Torsion requires immediate surgery to avoid permanent damage to the testes. Ultrasound also can be used to locate and evaluate masses (lumps or tumors) in the scrotum. The majority of scrotal masses are located outside of the testes. Most masses found outside the testicles are benign or non-cancerous; most inside the testicles are malignant or cancerous. Collections of fluid and abnormalities of the blood vessels may appear as masses and need to be assessed by ultrasound. Sample Images
What is Vascular Ultrasound Imaging? Ultrasound or sonography involves the sending of sound waves through the body. Those sound waves are reflected off the internal organs. The reflections are then interpreted by special instruments that subsequently create an image of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging. An ultrasound image is a useful way of evaluating the body's circulatory system. Ultrasound images are captured in real-time, so they can help radiologists monitor the blood flow to organs and tissues throughout the body, as well as evaluate the placement and success of repair, such as after arterial bypass surgery. With ultrasound images, radiologists can locate and identify blockages (stenosis) and abnormalities like blood clots, plaque or emboli, and help plan for their effective treatment. For a more detailed description of the ultrasound modality please refer to the Ultrasound page. How should I prepare for the procedure? You should wear comfortable, loose-fitting clothing for your ultrasound exam. No other preparation is required. If your abdominal vessels are being studied, you will need to fast before the procedure. What are some common uses of the procedure? Ultrasound imaging of the body's veins and arteries can help the radiologist see and evaluate blockages to blood flow, such as clots in veins and plaque in arteries. Ultrasound images may also be used to plan or review the success of procedures that repair aneurysms or bypass blood vessels. Patients with renal transplant often require vascular ultrasound to determine if the artery and vein of the transplant are normal and not affected by any narrowing related to the implantation surgery. Ultrasound of the veins may reveal blood clots that require treatment such as anticoagulant therapy (blood thinner), or placement of a vein filter to prevent clots from traveling to the lungs (embolism). Ultrasound of the vascular system also provides a fast, noninvasive means of identifying blockages of blood flow in the neck arteries to the brain that might produce a stroke or mini-stroke. Sample Images
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