text:
Medical ultrasound
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
This article is about using ultrasound to image the human body. For imaging of animals in research, see Preclinical imaging. For therapeutic use of ultrasound, see High-intensity focused ultrasound.
"Sonography" redirects here. For the tactile alphabet called "sonography", see Night writing.
Medical ultrasound
Sonographer doing echocardiography on a child
ICD-10-PCS
B?4
ICD-9-CM
88.7
MeSH
D014463
OPS-301 code
3-03...3-05
[edit on Wikidata]
Medical ultrasound (also known as diagnostic sonography or ultrasonography) is a diagnostic imaging technique based on the application of ultrasound. It is used to see internal body structures such as tendons, muscles, joints, blood vessels, and internal organs. Its aim is often to find a source of a disease or to exclude any pathology. The practice of examining pregnant women using ultrasound is called obstetric ultrasound, and is widely used.
Ultrasound is sound waves with frequencies which are higher than those audible to humans (>20,000 Hz). Ultrasonic images, also known as sonograms, are made by sending pulses of ultrasound into tissue using a probe. The sound echoes off the tissue; with different tissues reflecting varying degrees of sound. These echoes are recorded and displayed as an image to the operator.
Many different types of images can be formed using sonographic instruments. The most well-known type is a B-mode image, which displays the acoustic impedance of a two-dimensional cross-section of tissue. Other types of image can display blood flow, motion of tissue over time, the location of blood, the presence of specific molecules, the stiffness of tissue, or the anatomy of a three-dimensional region.
Compared to other prominent methods of medical imaging, ultrasound has several advantages. It provides images in real-time, it is portable and can be brought to the bedside, it is substantially lower in cost, and it does not use harmful ionizing radiation. Drawbacks of ultrasonography include various limits on its field of view, such as the need for patient cooperation, dependence on physique, difficulty imaging structures behind bone and air, and the necessity of a skilled operator, usually a trained professional.
Contents
1 By organ or system
1.1 Anesthesiology
1.2 Angiology (vascular)
1.3 Cardiology (heart)
1.4 Emergency medicine
1.5 Gastroenterology/Colorectal surgery
1.6 Gynecology and obstetrics
1.7 Otolaryngology (head and neck)
1.8 Neonatology
1.9 Ophthalmology (eyes)
1.10 Pulmonology (lungs)
1.11 Urology (urinary)
1.12 Scrotal
1.13 Musculoskeletal
1.14 Nephrology (kidneys)
2 From sound to image
2.1 Producing a sound wave
2.2 Receiving the echoes
2.3 Forming the image
2.4 Displaying the image
3 Sound in the body
4 Modes
5 Expansions
5.1 Doppler ultrasonography
5.2 Contrast ultrasonography (ultrasound contrast imaging)
5.3 Molecular ultrasonography (ultrasound molecular imaging)
5.4 Elastography (ultrasound elasticity imaging)
5.5 Interventional ultrasonography
5.6 Compression ultrasonography
6 Attributes
6.1 Strengths
6.2 Weaknesses
7 Risks and side-effects
7.1 Studies on the safety of ultrasound
8 Regulation
9 History
9.1 France
9.2 Scotland
9.3 Sweden
9.4 United States
10 Manufacturers
11 See also
12 References
13 External links
By organ or system[edit]
Sonography (ultrasonography) is widely used in medicine. It is possible to perform both diagnosis and therapeutic procedures, using ultrasound to guide interventional procedures (for instance biopsies or drainage of fluid collections). Sonographers are medical professionals who perform scans which are then typically interpreted by themselves or the radiologists, physicians who specialize in the application and interpretation of a wide variety of medical imaging modalities, or by cardiologists in the case of cardiac ultrasonography (echocardiography). Sonographers typically use a hand-held probe (called a transducer) that is placed directly on and moved over the patient. Increasingly, clinicians (physicians and other healthcare professionals who provide direct patient care) are using ultrasound in their office and hospital practices.
Sonography is effective for imaging soft tissues of the body. Superficial structures such as muscles, tendons, testes, breast, thyroid and parathyroid glands, 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.
A general-purpose ultrasound scanner may be used for most imaging purposes. Usually specialty applications may be served only by use of a specialty transducer. Most ultrasound procedures are done using a transducer on the surface of the body, but improved diagnostic confidence is often possible if a transducer can be placed inside the body. For this purpose, specialty transducers, including endovaginal, endorectal, and transesophageal transducers are commonly employed. At the extreme of this, very small transducers can be mounted on small diameter catheters and placed into blood vessels to image the walls and disease of those vessels.
Anesthesiology[edit]
In anesthesiology, Ultrasound is commonly used by anesthesiologists to guide injecting needles when placing local anaesthetic solutions near nerves. It is also used for gaining vascular access such as central venous cannulation and difficult arterial cannulation. Transcranial Doppler is frequently used by neuro-anesthesiologists for obtaining information about flow-velocity in the basal cerebral vessels.
Angiology (vascular)[edit]
Intravascular ultrasound image of a coronary artery (left), with color-coding on the right, delineating the lumen (yellow), external elastic membrane (blue) and the atherosclerotic plaque burden (green).
Further information: Doppler ultrasonography and Intravascular ultrasound
In angiology or vascular medicine, duplex ultrasound (B Mode vessels imaging combined with Doppler flow measurement) is daily used to diagnose arterial and venous disease all over the body. This is particularly important in neurology, where ultrasound is used for assessing blood flow and stenoses in the carotid arteries (Carotid ultrasonography) and the big intracerebral arteries (Transcranial Doppler).
Intravascular ultrasound (IVUS) is a methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound equipment. It allows the application of ultrasound technology, such as piezoelectric transducer or CMUT, to see from inside blood vessels out through the surrounding blood column, visualizing the endothelium (inner wall) of blood vessels in living individuals.[1]
On the legs, ultrasonography of deep venous thrombosis focuses on the deep veins, while ultrasonography of chronic venous insufficiency of the legs focuses on more superficial veins.
Cardiology (heart)[edit]
Main article: Echocardiography
Echocardiography is an essential tool in cardiology, to diagnose e.g. dilatation of parts of the heart and function of heart ventricles and valves
Emergency medicine[edit]
Main article: Emergency ultrasound
Point of care emergency ultrasound has many applications in emergency medicine, including the Focused Assessment with Sonography for Trauma (FAST) exam for assessing significant hemoperitoneum or pericardial tamponade after trauma. Ultrasound can be used for many other applications in the Emergency Department including evaluation for gallstones, kidney stones, fluid in the lungs or decreased cardiac output.
Gastroenterology/Colorectal surgery[edit]
Further information: Abdominal ultrasonography and Endoanal ultrasound
Abdominal and endoanal ultrasound are frequently used in gastroenterology and colorectal surgery. 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 and attenuated in different degree by fat, therefore there are limited diagnostic capabilities in this area. The appendix can sometimes be seen when inflamed (as in e.g.: appendicitis). Endoanal ultrasound is used particularly in the investigation of anorectal symptoms such as fecal incontinence or obstructed defecation. It images the immediate perianal anatomy and is able to detect occult defects such as tearing of the anal sphincter. Ultrasonography of liver tumors allows for both detection and characterization.[2]
Gynecology and obstetrics[edit]
Orthogonal planes of a 3 dimensional sonographic volume with transverse and coronal measurements for estimating fetal cranial volume.[3][4]
Main articles: gynecologic ultrasonography and Obstetric ultrasonography
Gynecologic ultrasonography examines female pelvic organs (specifically the uterus, the ovaries, and the Fallopian tubes) as well as the bladder, the adnexa, and the Pouch of Douglas. It commonly uses vaginal ultrasonography.
Obstetrical sonography is commonly used during pregnancy to check on the development of the fetus. It can be used to identify many conditions that would be harmful to the mother and the baby, many health care professionals consider the risk of leaving these conditions undiagnosed to be much greater than the very small risk, if any, associated with undergoing an ultrasound scan.
Even where sonography is used routinely in obstetric appointments during pregnancy, authorities discourage its use for non-medical purposes such as fetal "keepsake" videos and photos.[5]
Obstetric ultrasound is primarily used to:
Date the pregnancy (gestational age)
Confirm fetal viability
Determine location of fetus, intrauterine vs ectopic
Check the location of the placenta in relation to the cervix
Check for the number of fetuses (multiple pregnancy)
Check for major physical abnormalities.
Assess fetal growth (for evidence of intrauterine growth restriction (IUGR))
Check for fetal movement and heartbeat.
Determine the sex of the baby
According to the European Committee of Medical Ultrasound Safety (ECMUS)[6]
Ultrasonic examinations should only be performed by competent personnel who are trained and updated in safety matters. Ultrasound produces heating, pressure changes and mechanical disturbances in tissue. Diagnostic levels of ultrasound can produce temperature rises that are hazardous to sensitive organs and the embryo/fetus. Biological effects of non-thermal origin have been reported in animals but, to date, no such effects have been demonstrated in humans, except when a microbubble contrast agent is present.
Nonetheless, care should be taken to use low power settings and avoid pulsed wave scanning of the fetal brain unless specifically indicated in high risk pregnancies.
Ultrasound scanners have different Doppler-techniques to visualize arteries and veins. The most common is colour doppler or power doppler, but also other techniques like b-flow are used to show bloodflow in an organ. By using pulsed wave doppler or continuous wave doppler bloodflow velocities can be calculated.
Figures released for the period 2005–2006 by the UK Government (Department of Health) show that non-obstetric ultrasound examinations constituted more than 65% of the total number of ultrasound scans conducted.
Otolaryngology (head and neck)[edit]
Neck ultrasound.
Most structures of the neck, including the thyroid and parathryoid glands, lymph nodes, and salivary glands, are well-visualized by high-frequency ultrasound with exceptional anatomic detail. Ultrasound is the preferred imaging modality for thyroid tumors and lesions, and ultrasonography is critical in the evaluation, preoperative planning, and postoperative surveillance of patients with thyroid cancer. Many other benign and malignant conditions in the head and neck can be evaluated and managed with the help of diagnostic ultrasound and ultrasound-guided procedures.
Neonatology[edit]
In neonatology, transcranial Doppler can be used for basic assessment of intracerebral structural abnormalities, bleeds, ventriculomegaly or hydrocephalus and anoxic insults (Periventricular leukomalacia). The ultrasound can be performed through the soft spots in the skull of a newborn infant (Fontanelle) until these completely close at about 1 year of age and form a virtually impenetrable acoustic barrier for the ultrasound. The most common site for cranial ultrasound is the anterior fontanelle. The smaller the fontanelle, the poorer the quality of the picture.
Ophthalmology (eyes)[edit]
In ophthalmology and optometry, there are two major forms of eye exam using ultrasound:
A-scan ultrasound biometry, commonly referred to as an A-scan (short for Amplitude scan). It is an A-mode that provides data on the length of the eye, which is a major determinant in common sight disorders.
B-scan ultrasonography, or B-scan, which is a B-mode scan that produces a cross-sectional view of the eye and the orbit. It is commonly used to see inside the eye when media is hazy due to cataract or any corneal opacity.
Pulmonology (lungs)[edit]
In pulmonology, endobronchial Ultrasound (EBUS) probes are applied to standard flexible endoscopic probes and used by pulmonologists to allow for direct visualization of endobronchial lesions and lymph nodes prior to transbronchial needle aspiration. Among its many uses, EBUS aids in lung cancer staging by allowing for lymph node sampling without the need for major surgery.[7]
Urology (urinary)[edit]
Urinary bladder (black butterfly-like shape) and hyperplastic prostate (BPH) visualized by medical sonographic technique
Ultrasound is routinely used in urology to determine, for example, the amount of fluid retained in a patient's bladder. In a pelvic sonogram, organs of the pelvic region are imaged. This includes the uterus and ovaries or urinary bladder. Males are sometimes given a pelvic sonogram to check on the health of their bladder, the prostate, or their testicles (for example to distinguish epididymitis from testicular torsion). In young males, it is used to distinguish more benign testicular masses (varicocele or hydrocele) from testicular cancer, which is highly curable but which must be treated to preserve health and fertility. 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. It is used to diagnose and, at higher frequencies, to treat (break up) kidney stones or kidney crystals (nephrolithiasis).[8]
Scrotal[edit]
Main article: Scrotal ultrasound
Scrotal ultrasonography is used in the evaluation of testicular pain, and can help identify solid masses.[9]
Musculoskeletal[edit]
Musculoskeletal ultrasound in used to examine tendons, muscles, nerves, ligaments, soft tissue masses, and bone surfaces.[10] Ultrasound is an alternative to x-ray imaging in detecting fractures of the wrist, elbow and shoulder for patients up to 12 years (Fracture sonography).
Quantitative ultrasound is an adjunct musculoskeletal test for myopathic disease in children;[11][12] estimates of lean body mass in adults;[13] proxy measures of muscle quality (i.e., tissue composition)[14] in older adults with sarcopenia[15][16]
Nephrology (kidneys)[edit]
Main article: Renal ultrasonography
In nephrology, ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. US is an accessible, versatile, inexpensive, and fast aid for decision-making in patients with renal symptoms and for guidance in renal intervention.[17] Renal ultrasound (US) is a common examination, which has been performed for decades. Using B-mode imaging, assessment of renal anatomy is easily performed, and US is often used as image guidance for renal interventions. Furthermore, novel applications in renal US have been introduced with contrast-enhanced ultrasound (CEUS), elastography and fusion imaging. However, renal US has certain limitations, and other modalities, such as CT and MRI, should always be considered as supplementary imaging modalities in the assessment of renal disease.[17]
From sound to image[edit]
The creation of an image from sound is done in three steps – producing a sound wave, receiving echoes, and interpreting those echoes.
Producing a sound wave[edit]
Medical ultrasound scanner
A sound wave is typically produced by a piezoelectric transducer encased in a plastic housing. Strong, short electrical pulses from the ultrasound machine drive the transducer at the desired frequency. The frequencies can be anywhere between 1 and 18 MHz, though frequencies up to 50–100 megahertz have been used experimentally in a technique known as biomicroscopy in special regions, such as the anterior chamber of the eye.[18] Older technology transducers focused their beam with physical lenses. Newer technology transducers use phased array techniques to enable the ultrasound machine to change the direction and depth of focus.
The sound is focused either by the shape of the transducer, a lens in front of the transducer, or a complex set of control pulses from the ultrasound scanner, in the (beamforming) technique. This focusing produces an arc-shaped sound wave from the face of the transducer. The wave travels into the body and comes into focus at a desired depth.
Materials on the face of the transducer enable the sound to be transmitted efficiently into the body (often a rubbery coating, a form of impedance matching). In addition, a water-based gel is placed between the patient's skin and the probe.
The sound wave is partially reflected from the layers between different tissues or scattered from smaller structures. Specifically, sound is reflected anywhere where there are acoustic impedance changes in the body: e.g. blood cells in blood plasma, small structures in organs, etc. Some of the reflections return to the transducer.
Receiving the echoes[edit]
The return of the sound wave to the transducer results in the same process as sending the sound wave, except in reverse. The returned sound wave vibrates the transducer and the transducer turns the vibrations into electrical pulses that travel to the ultrasonic scanner where they are processed and transformed into a digital image.
Forming the image[edit]
To make an image, the ultrasound scanner must determine two things from each received echo:
How long it took the echo to be received from when the sound was transmitted.
How strong the echo was.
Once the ultrasonic scanner determines these two things, it can locate which pixel in the image to light up and to what intensity.
Transforming the received signal into a digital image may be explained by using a blank spreadsheet as an analogy. First picture a long, flat transducer at the top of the sheet. Send pulses down the 'columns' of the spreadsheet (A, B, C, etc.). Listen at each column for any return echoes. When an echo is heard, note how long it took for the echo to return. The longer the wait, the deeper the row (1,2,3, etc.). The strength of the echo determines the brightness setting for that cell (white for a strong echo, black for a weak echo, and varying shades of grey for everything in between.) When all the echoes are recorded on the sheet, we have a greyscale image.
Displaying the image[edit]
Images from the ultrasound scanner are transferred and displayed using the DICOM standard. Normally, very little post processing is applied to ultrasound images.
Sound in the body[edit]
Linear array transducer
Ultrasonography (sonography) uses a probe containing multiple acoustic transducers to send pulses of sound into a material. Whenever a sound wave encounters a material with a different density (acoustical impedance), part of the sound wave is reflected back to the probe and is detected as an echo. The time it takes for the echo to travel back to the probe is measured and used to calculate the depth of the tissue interface causing the echo. The greater the difference between acoustic impedances, the larger the echo is. If the pulse hits gases or solids, the density difference is so great that most of the acoustic energy is reflected and it becomes impossible to see deeper.
The frequencies used for medical imaging are generally in the range of 1 to 18 MHz. Higher frequencies have a correspondingly smaller wavelength, and can be used to make sonograms with smaller details. However, the attenuation of the sound wave is increased at higher frequencies, so in order to have better penetration of deeper tissues, a lower frequency (3–5 MHz) is used.
Seeing deep into the body with sonography is very difficult. Some acoustic energy is lost every time an echo is formed, but most of it (approximately 0.5 dB cm depth ⋅ MHz {\displaystyle \textstyle 0.5{\frac {\mbox{dB}}{{\mbox{cm depth}}\cdot {\mbox{MHz}}}}} ) is lost from acoustic absorption. (See also Acoustic attenuation for further details on modeling of acoustic attenuation and absorption.)
The speed of sound varies as it travels through different materials, and is dependent on the acoustical impedance of the material. However, the sonographic instrument assumes that the acoustic velocity is constant at 1540 m/s. An effect of this assumption is that in a real body with non-uniform tissues, the beam becomes somewhat de-focused and image resolution is reduced.
To generate a 2D-image, the ultrasonic beam is swept. A transducer may be swept mechanically by rotating or swinging. Or a 1D phased array transducer may be used to sweep the beam electronically. The received data is processed and used to construct the image. The image is then a 2D representation of the slice into the body.
3D images can be generated by acquiring a series of adjacent 2D images. Commonly a specialised probe that mechanically scans a conventional 2D-image transducer is used. However, since the mechanical scanning is slow, it is difficult to make 3D images of moving tissues. Recently, 2D phased array transducers that can sweep the beam in 3D have been developed. These can image faster and can even be used to make live 3D images of a beating heart.
Doppler ultrasonography is used to study blood flow and muscle motion. The different detected speeds are represented in color for ease of interpretation, for example leaky heart valves: the leak shows up as a flash of unique color. Colors may alternatively be used to represent the amplitudes of the received echoes.
Modes[edit]
Several modes of ultrasound are used in medical imaging.[19][20] These are:
A-mode: A-mode (amplitude mode) is the simplest type of ultrasound. A single transducer scans a line through the body with the echoes plotted on screen as a function of depth. Therapeutic ultrasound aimed at a specific tumor or calculus is also A-mode, to allow for pinpoint accurate focus of the destructive wave energy.
B-mode or 2D mode: In B-mode (brightness mode) ultrasound, a linear array of transducers simultaneously scans a plane through the body that can be viewed as a two-dimensional image on screen. More commonly known as 2D mode now.
B-flow image of venous reflux.
Video is available
B-flow is a mode that digitally highlights weak flow reflectors (mainly red blood cells) while suppressing the signals from the surrounding stationary tissue. It can visualize flowing blood and surrounding stationary tissues simultaneously.[21] It is thus an alternative or complement to Doppler ultrasonography in visualizing blood flow.[22]
C-mode: A C-mode image is formed in a plane normal to a B-mode image. A gate that selects data from a specific depth from an A-mode line is used; then the transducer is moved in the 2D plane to sample the entire region at this fixed depth. When the transducer traverses the area in a spiral, an area of 100 cm2 can be scanned in around 10 seconds.[20]
M-mode: In M-mode (motion mode) ultrasound, pulses are emitted in quick succession – each time, either an A-mode or B-mode image is taken. Over time, this is analogous to recording a video in ultrasound. As the organ boundaries that produce reflections move relative to the probe, this can be used to determine the velocity of specific organ structures.
Doppler mode: This mode makes use of the Doppler effect in measuring and visualizing blood flow
Color Doppler: Velocity information is presented as a color-coded overlay on top of a B-mode image
Continuous wave (CW) Doppler: Doppler information is sampled along a line through the body, and all velocities detected at each time point are presented (on a time line)
Pulsed wave (PW) Doppler: Doppler information is sampled from only a small sample volume (defined in 2D image), and presented on a timeline
Duplex: a common name for the simultaneous presentation of 2D and (usually) PW Doppler information. (Using modern ultrasound machines, color Doppler is almost always also used; hence the alternative name Triplex.)
Pulse inversion mode: In this mode, two successive pulses with opposite sign are emitted and then subtracted from each other. This implies that any linearly responding constituent will disappear while gases with non-linear compressibility stand out. Pulse inversion may also be used in a similar manner as in Harmonic mode; see below:
Harmonic mode: In this mode a deep penetrating fundamental frequency is emitted into the body and a harmonic overtone is detected. This way noise and artifacts due to reverberation and aberration are greatly reduced. Some also believe that penetration depth can be gained with improved lateral resolution; however, this is not well documented.
Expansions[edit]
An additional expansion or additional technique of ultrasound is biplanar ultrasound, in which the probe has two 2D planes that are perpendicular to each other, providing more efficient localization and detection.[23] Furthermore, an omniplane probe is one that can rotate 180° to obtain multiple images.[23] In 3D ultrasound, many 2D planes are digitally added together to create a 3-dimensional image of the object.
Doppler ultrasonography[edit]
Main article: Doppler ultrasonography
Duplex scan of the common carotid artery
Doppler ultrasonography employs the Doppler effect to assess whether structures (usually blood)[24] are moving towards or away from the probe, and its relative velocity. By calculating the frequency shift of a particular sample volume, for example flow in an artery or a jet of blood flow over a heart valve, its speed and direction can be determined and visualized. Color Doppler is the measurement of velocity by color scale. Color Doppler images are generally combined with grayscale (B-mode) images to display duplex ultrasonography images. Uses include:
Doppler echocardiography, the use of Doppler ultrasonography to examine the heart.[25] An echocardiogram can, within certain limits, produce accurate assessment of the direction of blood flow and the velocity of blood and cardiac tissue at any arbitrary point using the Doppler effect. Velocity measurements allow assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), calculation of the cardiac output and calculation of E/A ratio[26] (a measure of diastolic dysfunction). Contrast-enhanced ultrasound using gas-filled microbubble contrast media can be used to improve velocity or other flow-related medical measurements.
Transcranial Doppler (TCD) and transcranial color Doppler (TCCD), which measure the velocity of blood flow through the brain's blood vessels transcranially (through the cranium). They are used as tests to help diagnose emboli, stenosis, vasospasm from a subarachnoid hemorrhage (bleeding from a ruptured aneurysm), and other problems.
Doppler fetal monitors, although usually not technically -graphy but rather sound-generating, use the Doppler effect to detect the fetal heartbeat for prenatal care. These are hand-held, and some models also display the heart rate in beats per minute (BPM). Use of this monitor is sometimes known as Doppler auscultation. The Doppler fetal monitor is commonly referred to simply as a Doppler or fetal Doppler. Doppler fetal monitors provide information about the fetus similar to that provided by a fetal stethoscope.
Contrast ultrasonography (ultrasound contrast imaging)[edit]
Main article: Contrast-enhanced ultrasound
A contrast medium for medical ultrasonography is a formulation of encapsulated gaseous microbubbles[27] to increase echogenicity of blood, discovered by Dr Raymond Gramiak in 1968[28] and named contrast-enhanced ultrasound. This contrast medical imaging modality is clinically used throughout the world,[29] in particular for echocardiography in the United States and for ultrasound radiology in Europe and Asia.
Microbubbles-based contrast media is administrated intravenously in patient blood stream during the medical ultrasonography examination. The microbubbles being too large in diameter, they stay confined in blood vessels and cannot extravasate towards the interstitial fluid. An ultrasound contrast media is therefore purely intravascular, making it an ideal agent to image organ microvascularization for diagnostic purposes. A typical clinical use of contrast ultrasonography is detection of a hypervascular metastatic tumor, which exhibits a contrast uptake (kinetics of microbubbles concentration in blood circulation) faster than healthy biological tissue surrounding the tumor.[30] Other clinical applications using contrast exist, such as in echocardiography to improve delineation of left ventricle for visually checking contractibility of heart after a myocardial infarction. Finally, applications in quantitative perfusion[31] (relative measurement of blood flow [32]) emerge for identifying early patient response to an anti-cancerous drug treatment (methodology and clinical study by Dr Nathalie Lassau in 2011[33]), enabling to determine the best oncological therapeutic options.[34]
Parametric imaging of vascular signatures (diagram)
In oncological practice of medical contrast ultrasonography, clinicians use the method of parametric imaging of vascular signatures[35] invented by Dr Nicolas Rognin in 2010.[36] This method is conceived as a cancer aided diagnostic tool, facilitating characterization of a suspicious tumor (malignant versus benign) in an organ. This method is based on medical computational science [37][38] to analyze a time sequence of ultrasound contrast images, a digital video recorded in real-time during patient examination. Two consecutive signal processing steps are applied to each pixel of the tumor:
calculation of a vascular signature (contrast uptake difference with respect to healthy tissue surrounding the tumor);
automatic classification of the vascular signature into a unique parameter, this last coded in one of the four following colors:
green for continuous hyper-enhancement (contrast uptake higher than healthy tissue one),
blue for continuous hypo-enhancement (contrast uptake lower than healthy tissue one),
red for fast hyper-enhancement (contrast uptake before healthy tissue one) or
yellow for fast hypo-enhancement (contrast uptake after healthy tissue one).
Once signal processing in each pixel completed, a color spatial map of the parameter is displayed on a computer monitor, summarizing all vascular information of the tumor in a single image called parametric image (see last figure of press article [39] as clinical examples). This parametric image is interpreted by clinicians based on predominant colorization of the tumor: red indicates a suspicion of malignancy (risk of cancer), green or yellow – a high probability of benignity. In the first case (suspicion of malignant tumor), the clinician typically prescribes a biopsy to confirm the diagnostic or a CT scan examination as a second opinion. In the second case (quasi-certain of benign tumor), only a follow-up is needed with a contrast ultrasonography examination a few months later. The main clinical benefits are to avoid a systematic biopsy (risky invasive procedure) of benign tumors or a CT scan examination exposing the patient to X-ray radiation. The parametric imaging of vascular signatures method proved to be effective in humans for characterization of tumors in the liver.[40] In a cancer screening context, this method might be potentially applicable to other organs such as breast[41] or prostate.
Molecular ultrasonography (ultrasound molecular imaging)[edit]
The future of contrast ultrasonography is in molecular imaging with potential clinical applications expected in cancer screening to detect malignant tumors at their earliest stage of appearance. Molecular ultrasonography (or ultrasound molecular imaging) uses targeted microbubbles originally designed by Dr Alexander Klibanov in 1997;[42][43] such targeted microbubbles specifically bind or adhere to tumoral microvessels by targeting biomolecular cancer expression (overexpression of certain biomolecules occurs during neo-angiogenesis[44][45] or inflammation[46] processes in malignant tumors). As a result, a few minutes after their injection in blood circulation, the targeted microbubbles accumulate in the malignant tumor; facilitating its localization in a unique ultrasound contrast image. In 2013, the very first exploratory clinical trial in humans for prostate cancer was completed at Amsterdam in the Netherlands by Dr Hessel Wijkstra.[47]
In molecular ultrasonography, the technique of acoustic radiation force (also used for shear wave elastography) is applied in order to literally push the targeted microbubbles towards microvessels wall; firstly demonstrated by Dr Paul Dayton in 1999.[48] This allows maximization of binding to the malignant tumor; the targeted microbubbles being in more direct contact with cancerous biomolecules expressed at the inner surface of tumoral microvessels. At the stage of scientific preclinical research, the technique of acoustic radiation force was implemented as a prototype in clinical ultrasound systems and validated in vivo in 2D[49] and 3D[50][51] imaging modes.
Elastography (ultrasound elasticity imaging)[edit]
Main article: Elastography
Ultrasound is also used for elastography, which is a relatively new imaging modality that maps the elastic properties of soft tissue.[52][53] This modality emerged in the last two decades. Elastography is useful in medical diagnoses as it can discern healthy from unhealthy tissue for specific organs/growths. For example, cancerous tumors will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones.[52][53][54][55]
There are many ultrasound elastography techniques.[53]
Interventional ultrasonography[edit]
Interventional ultrasonography involves biopsy, emptying fluids, intrauterine Blood transfusion (Hemolytic disease of the newborn).
Thyroid cysts: The high frequency thyroid ultrasound (HFUS) can be used to treat several gland conditions. The recurrent thyroid cyst that was usually treated in the past with surgery, can be treated effectively by a new procedure called percutaneous ethanol injection, or PEI. With ultrasound guided placement of a 25 gauge needle within the cyst, and after evacuation of the cyst fluid, about 50% of the cyst volume is injected back into the cavity, under strict operator visualization of the needle tip. The procedure is 80% successful in reducing the cyst to minute size.
Metastatic thyroid cancer neck lymph nodes: The other thyroid therapy use for HFUS is to treat metastatic thyroid cancer neck lymph nodes that occur in patients who either refuse surgery, or are no longer a candidate for surgery. Small amounts of ethanol are injected under ultrasound guided needle placement. A blood flow study is done prior to the injection, by power doppler. The blood flow can be destroyed and the node become inactive, although it may still be there. Power doppler visualized blood flow can be eradicated, and there may be a drop in the cancer blood marker test, thyroglobulin, TG, as the node become non-functional. Another interventional use for HFUS is to mark a cancer node one hour prior to surgery to help locate the node cluster at the surgery. A minute amount of methylene dye is injected, under careful ultrasound guided placement of the needle on the anterior surface, but not in the node. The dye will be evident to the thyroid surgeon when he opens the neck. A similar localization procedure with methylene blue, can be done to locate parathyroid adenomas at surgery.
Compression ultrasonography[edit]
Compression ultrasonography is when the probe is pressed against the skin. This can bring the target structure closer to the probe, increasing spatial resolution of it. Comparison of the shape of the target structure before and after compression can aid in diagnosis.
It used in ultrasonography of deep venous thrombosis, wherein absence of vein compressibility is a strong indicator of thrombosis.[56] Compression ultrasonography has both high sensitivity and specificity for detecting proximal deep vein thrombosis only in symptomatic patients. Results are not reliable when the patient is symptomless and must be checked, for example in high risk postoperative patients mainly in orthopedic patients.[57][58]
A normal appendix without and with compression. Absence of comprehensibility indicates appendicitis.[59]
Compression is used in this ultrasonograph to get closer to the abdominal aorta, making the superior mesenteric vein and the inferior vena cava look rather flat.
Attributes[edit]
As with all imaging modalities, ultrasonography has its list of positive and negative attributes.
Strengths[edit]
It images muscle, soft tissue, and bone surfaces very well and is particularly useful for delineating the interfaces between solid and fluid-filled spaces.
It renders "live" images, where the operator can dynamically select the most useful section for diagnosing and documenting changes, often enabling rapid diagnoses. Live images also allow for ultrasound-guided biopsies or injections, which can be cumbersome with other imaging modalities.
It shows the structure of organs.
It has no known long-term side effects and rarely causes any discomfort to the patient.
Equipment is widely available and comparatively flexible.
Small, easily carried scanners are available; examinations can be performed at the bedside.
Relatively inexpensive compared to other modes of investigation, such as computed X-ray tomography, DEXA or magnetic resonance imaging.
Spatial resolution is better in high frequency ultrasound transducers than it is in most other imaging modalities.
Through the use of an ultrasound research interface, an ultrasound device can offer a relatively inexpensive, real-time, and flexible method for capturing data required for special research purposes for tissue characterization and development of new image processing techniques
Weaknesses[edit]
Double aort artifact in sonography due to difference in velocity of sound waves in muscle and fat.
Sonographic devices have trouble penetrating bone. For example, sonography of the adult brain is currently very limited.
Sonography performs very poorly when there is a gas between the transducer and the organ of interest, due to the extreme differences in acoustic impedance. For example, overlying gas in the gastrointestinal tract often makes ultrasound scanning of the pancreas difficult. Lung imaging however can be useful in demarcating pleural effusions, detecting heart failure, and detecting pneumonia.[60]
Even in the absence of bone or air, the depth penetration of ultrasound may be limited depending on the frequency of imaging. Consequently, there might be difficulties imaging structures deep in the body, especially in obese patients.
Physique has a large influence on image quality. Image quality and accuracy of diagnosis is limited with obese patients, overlying subcutaneous fat attenuates the sound beam and a lower frequency transducer is required (with lower resolution)
The method is operator-dependent. A high level of skill and experience is needed to acquire good-quality images and make accurate diagnoses.
There is no scout image as there is with CT and MRI. Once an image has been acquired there is no exact way to tell which part of the body was imaged.
Risks and side-effects[edit]
Ultrasonography is generally considered safe imaging,[61] with the World Health Organizations saying:[62]
"Diagnostic ultrasound is recognized as a safe, effective, and highly flexible imaging modality capable of providing clinically relevant information about most parts of the body in a rapid and cost-effective fashion".
Diagnostic ultrasound studies of the fetus are generally considered to be safe during pregnancy. This diagnostic procedure should be performed only when there is a valid medical indication, and the lowest possible ultrasonic exposure setting should be used to gain the necessary diagnostic information under the "as low as reasonably practicable" or ALARP principle.
However, medical ultrasonography should not be performed without a medical indication to perform it. To do otherwise would be to perform unnecessary health care to patients, which bring unwarranted costs and may lead to other testing. Overuse of ultrasonography is sometimes as routine as screening for deep vein thrombosis after orthopedic surgeries in patients who are not at heightened risk for having that condition.[63]
Similarly, although there is no evidence ultrasound could be harmful for the fetus, medical authorities typically strongly discourage the promotion, selling, or leasing of ultrasound equipment for making "keepsake fetal videos".[5][64]
Studies on the safety of ultrasound[edit]
A meta-analysis of several ultrasonography studies published in 2000 found no statistically significant harmful effects from ultrasonography, but mentioned that there was a lack of data on long-term substantive outcomes such as neurodevelopment.[65]
A study at the Yale School of Medicine published in 2006 found a small but significant correlation between prolonged and frequent use of ultrasound and abnormal neuronal migration in mice.[66]
A study performed in Sweden in 2001[67] has shown that subtle effects of neurological damage linked to ultrasound were implicated by an increased incidence in left-handedness in boys (a marker for brain problems when not hereditary) and speech delays.[68][69]
The above findings, however, were not confirmed in a later follow-up study.[70]
A later study, however, performed on a larger sample of 8865 children, has established a statistically significant, albeit weak association of ultrasonography exposure and being non-right handed later in life.[71] (See Handedness#Ultrasound).
Regulation[edit]
Diagnostic and therapeutic ultrasound equipment is regulated in the USA by the Food and Drug Administration, and worldwide by other national regulatory agencies. The FDA limits acoustic output using several metrics; generally, other agencies accept the FDA-established guidelines.
Currently, New Mexico, Oregon, and North Dakota are the only US states that regulate diagnostic medical sonographers.[72] Certification examinations for sonographers are available in the US from three organizations: the American Registry for Diagnostic Medical Sonography, Cardiovascular Credentialing International and the American Registry of Radiologic Technologists.[citation needed]
The primary regulated metrics are Mechanical Index (MI), a metric associated with the cavitation bio-effect, and Thermal Index (TI) a metric associated with the tissue heating bio-effect. The FDA requires that the machine not exceed established limits, which are reasonably conservative so as to maintain diagnostic ultrasound as a safe imaging modality. This requires self-regulation on the part of the manufacturer in terms of the machine's calibration.[73]
Ultrasound-based pre-natal care and sex screening technologies were launched in India in the 1980s. With concerns about its misuse for sex-selective abortion, the Government of India passed the Pre-natal Diagnostic Techniques Act (PNDT) in 1994 to regulate legal and illegal uses of ultrasound equipment.[74] The law was further amended into the Pre-Conception and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) (PCPNDT) Act in 2004 to deter and punish prenatal sex screening and sex selective abortion.[75] It is currently illegal and a punishable crime in India to determine or disclose the sex of a fetus using ultrasound equipment.[76]
History[edit]
After the French physicist Pierre Curie’s discovery of piezoelectricity in 1880, ultrasonic waves could be deliberately generated for industry. Thereafter, in 1940, the American acoustical physicist Floyd Firestone devised the first ultrasonic echo imaging device, the Supersonic Reflectoscope, to detect internal flaws in metal castings. In 1941, the Austrian neurologist Karl Theo Dussik was in collaboration with his brother, Friedreich, a physicist, likely, the first person to ultrasonically echo image the human body, outlining thereby the ventricles of a human brain.[77][78] Ultrasonic energy was first applied to the human body for medical purposes by Dr George Ludwig at the Naval Medical Research Institute, Bethesda, Maryland in the late 1940s.[79][80] English-born physicist John Wild (1914–2009) first used ultrasound to assess the thickness of bowel tissue as early as 1949; he has been described as the "father of medical ultrasound".[81] Subsequent advances in the field took place concurrently in several countries. But it was not until 1963 when Meyerdirk & Wright launched production of the first commercial hand-held articulated arm compound contact B-mode scanner that ultrasound became generally available for medical use.
France[edit]
Léandre Pourcelot, who was a researcher and teacher at INSA (Institut National des Sciences Appliquées) Lyon copublished in 1965 a report at "Académie des sciences" « Effet Doppler et mesure du débit sanguin » (Doppler effect and measure of the blood flow), the basis of his design of a Doppler flow meter in 1967.
In his book "L'investigation vasculaire par ultrasonographie Doppler" (Ed Masson, 1977) [24] Dr Claude Franceschi laid down the Doppler Ultrasound fundamentals of the hemodynamics semiotics, which are still in use in current Doppler arterial and venous Duplex Ultrasound investigations.
Scotland[edit]
Parallel developments in Glasgow, Scotland by Professor Ian Donald and colleagues at the Glasgow Royal Maternity Hospital (GRMH) led to the first diagnostic applications of the technique.[82] Donald was an obstetrician with a self-confessed "childish interest in machines, electronic and otherwise", who, having treated the wife of one of the company's directors, was invited to visit the Research Department of boilermakers Babcock & Wilcox at Renfrew, where he used their industrial ultrasound equipment to conduct experiments on various morbid anatomical specimens and assess their ultrasonic characteristics. Together with the medical physicist Tom Brown (Wikidata; Reasonator).[83] and fellow obstetrician Dr John MacVicar, Donald refined the equipment to enable differentiation of pathology in live volunteer patients. These findings were reported in The Lancet on 7 June 1958[84] as "Investigation of Abdominal Masses by Pulsed Ultrasound" – possibly one of the most important papers ever published in the field of diagnostic medical imaging.
At GRMH, Professor Donald and Dr James Willocks then refined their techniques to obstetric applications including fetal head measurement to assess the size and growth of the fetus. With the opening of the new Queen Mother's Hospital in Yorkhill in 1964, it became possible to improve these methods even further. Dr Stuart Campbell's pioneering work on fetal cephalometry led to it acquiring long-term status as the definitive method of study of foetal growth. As the technical quality of the scans was further developed, it soon became possible to study pregnancy from start to finish and diagnose its many complications such as multiple pregnancy, fetal abnormality and placenta praevia. Diagnostic ultrasound has since been imported into practically every other area of medicine.
Sweden[edit]
Medical ultrasonography was used in 1953 at Lund University by cardiologist Inge Edler and Gustav Ludwig Hertz's son Carl Hellmuth Hertz, who was then a graduate student at the University's department of nuclear physics.
Edler had asked Hertz if it was possible to use radar to look into the body, but Hertz said this was impossible. However, he said, it might be possible to use ultrasonography. Hertz was familiar with using ultrasonic reflectoscopes of the American acoustical physicist Floyd Firestone's invention for nondestructive materials testing, and together Edler and Hertz developed the idea of using this method in medicine.
The first successful measurement of heart activity was made on October 29, 1953 using a device borrowed from the ship construction company Kockums in Malmö. On December 16 the same year, the method was used to generate an echo-encephalogram (ultrasonic probe of the brain). Edler and Hertz published their findings in 1954.[85]
United States[edit]
In 1962, after about two years of work, Joseph Holmes, William Wright, and Ralph Meyerdirk developed the first compound contact B-mode scanner. Their work had been supported by U.S. Public Health Services and the University of Colorado. Wright and Meyerdirk left the University to form Physionic Engineering Inc., which launched the first commercial hand-held articulated arm compound contact B-mode scanner in 1963. This was the start of the most popular design in the history of ultrasound scanners.[86]
In the late 1960s Dr Gene Strandness and the bio-engineering group at the University of Washington conducted research on Doppler ultrasound as a diagnostic tool for vascular disease. Eventually, they developed technologies to use duplex imaging, or Doppler in conjunction with B-mode scanning, to view vascular structures in real-time, while also providing hemodynamic information.[87]
The first demonstration of color Doppler was by Geoff Stevenson, who was involved in the early developments and medical use of Doppler shifted ultrasonic energy.[88]
Manufacturers[edit]
The leading manufacturers of Ultrasound Equipment are Siemens Healthineers, GE Healthcare, and Philips.[89]
See also[edit]
Doppler fetal monitor
Elastography
Polybiography
Radiographer
Ultrasound computer tomography
Ultrasound transmission tomography
References[edit]
Jump up ^ Hector M. Garcia-Garcia, Bill D. Gogas, Patrick W. Serruys & Nico Bruining (2011). "IVUS-based imaging modalities for tissue characterization: similarities and differences". The international journal of cardiovascular imaging. 27 (2): 215–224. doi:10.1007/s10554-010-9789-7. PMC 3078312  . PMID 21327914. CS1 maint: Multiple names: authors list (link)
Jump up ^ Content originally copied from: Badea, R.; Ioanitescu, Simona (2012). "Ultrasound Imaging of Liver Tumors – Current Clinical Applications". doi:10.5772/31137. , (CC BY 3.0)
Jump up ^ Dubose, T. J. (1985). "Fetal Biometry: Vertical Calvarial Diameter and Calvarial Volume". Journal of Diagnostic Medical Sonography. 1 (5): 205–217. doi:10.1177/875647938500100504.
Jump up ^ "3D BPD Correction". July 2000. Retrieved 2015-01-14. [permanent dead link]
^ Jump up to: a b "Avoid Fetal "Keepsake" Images, Heartbeat Monitors". U.S. food and Drug Administration. U.S. Government. Retrieved 11 September 2017.
Jump up ^ Clinical Safety Statements Archived 2012-06-26 at the Wayback Machine.. Efsumb.org. Retrieved on 2011-11-13.
Jump up ^ Herth, F J F; Eberhardt, R; Vilmann, P; Krasnik, M; Ernst, A (2006). "Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes". Thorax. 61 (9): 795–8. doi:10.1136/thx.2005.047829. PMC 2117082  . PMID 16738038.
Jump up ^ Piloni, Vittorio Luigi; Spazzafumo, Liana (June 2007). "Sonography of the female pelvic floor:clinical indications and techniques". Pelviperineology. 26 (2): 59–65.
Jump up ^ Sam D. Graham; Thomas E Keane (25 September 2009). Glenn's Urologic Surgery. Lippincott Williams & Wilkins. pp. 433–. ISBN 978-0-7817-9141-0. Retrieved 1 July 2011.
Jump up ^ Arend CF. Ultrasound of the Shoulder. Porto Alegre: Master Medical Books; 2013. (Free access at ShoulderUS.com)[page needed]
Jump up ^ Zaidman, Craig M.; van Alfen, Nens (2016-04-01). "Ultrasound in the Assessment of Myopathic Disorders". Journal of Clinical Neurophysiology. 33 (2): 103–111. doi:10.1097/WNP.0000000000000245. PMID 27035250.
Jump up ^ Harris-Love, Michael O.; Monfaredi, Reza; Ismail, Catheeja; Blackman, Marc R.; Cleary, Kevin (2014-01-01). "Quantitative ultrasound: measurement considerations for the assessment of muscular dystrophy and sarcopenia". Frontiers in Aging Neuroscience. 6: 172. doi:10.3389/fnagi.2014.00172. PMC 4094839  . PMID 25071570.
Jump up ^ Abe, Takashi; Loene, Jeremy P.; Young, Kaelin C.; Thiebaud, Robert S.; Nahar, Vinayak K.; Hollaway, Kaitlyn M.; Stover, Caitlin D.; Ford, M. Allison; Bass, Martha A. (2015-02-01). "Validity of ultrasound prediction equations for total and regional muscularity in middle-aged and older men and women". Ultrasound in Medicine & Biology. 41 (2): 557–564. doi:10.1016/j.ultrasmedbio.2014.09.007. PMID 25444689.
Jump up ^ McGregor, Robin A.; Cameron-Smith, David; Poppitt, Sally D. (2014-01-01). "It is not just muscle mass: a review of muscle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life". Longevity & Healthspan. 3 (1): 9. doi:10.1186/2046-2395-3-9. PMC 4268803  . PMID 25520782.
Jump up ^ Watanabe, Yuya; Yamada, Yosuke; Fukumoto, Yoshihiro; Ishihara, Tatsuro; Yokoyama, Keiichi; Yoshida, Tsukasa; Miyake, Motoko; Yamagata, Emi; Kimura, Misaka (2013-01-01). "Echo intensity obtained from ultrasonography images reflecting muscle strength in elderly men". Clinical Interventions in Aging. 8: 993–998. doi:10.2147/CIA.S47263. PMC 3732157  . PMID 23926426.
Jump up ^ Ismail, Catheeja; Zabal, Johannah; Hernandez, Haniel J.; Woletz, Paula; Manning, Heather; Teixeira, Carla; DiPietro, Loretta; Blackman, Marc R.; Harris-Love, Michael O. (2015-01-01). "Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia". Frontiers in Physiology. 6: 302. doi:10.3389/fphys.2015.00302. PMC 4625057  . PMID 26578974.
^ Jump up to: a b Content initially copied from: Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline (2015). "Ultrasonography of the Kidney: A Pictorial Review". Diagnostics. 6 (1): 2. doi:10.3390/diagnostics6010002. ISSN 2075-4418. (CC-BY 4.0)
Jump up ^ Pavlin, Charles; Foster, F. Stuart (1994). Ultrasound Biomicroscopy of the Eye. Springer. ISBN 0-387-94206-8.
Jump up ^ The Gale Encyclopedia of Medicine, 2nd Edition, Vol. 1 A-B. p. 4
^ Jump up to: a b Cobbold, Richard S. C. (2007). Foundations of Biomedical Ultrasound. Oxford University Press. pp. 422–423. ISBN 978-0-19-516831-0.
Jump up ^ Wang, Hsin-Kai; Chou, Yi-Hong; Chiou, Hong-Jen; Chiou, See-Ying; Chang, Cheng-Yen (2005). "B-flow Ultrasonography of Peripheral Vascular Diseases". Journal of Medical Ultrasound. 13 (4): 186–195. doi:10.1016/S0929-6441(09)60108-9. ISSN 0929-6441.
Jump up ^ Wachsberg, Ronald H. (2007). "B-Flow Imaging of the Hepatic Vasculature: Correlation with Color Doppler Sonography". American Journal of Roentgenology. 188 (6): W522–W533. doi:10.2214/AJR.06.1161. ISSN 0361-803X.
^ Jump up to: a b Page 161 (part II > Two-dimensional Echocardiography) in: Reves, J. G.; Estafanous, Fawzy G.; Barash, Paul G. (2001). Cardiac anesthesia: principles and clinical practice. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-2195-4.
^ Jump up to: a b Claude Franceschi (1978). L'Investigation vasculaire par ultrasonographie doppler. Masson. ISBN 2-225-63679-6.
Jump up ^ "Echocardiogram". MedlinePlus. Retrieved 2017-12-15.
Jump up ^ [1] Abdul Latif Mohamed, Jun Yong, Jamil Masiyati, Lee Lim, Sze Chec Tee. The Prevalence Of Diastolic Dysfunction In Patients With Hypertension Referred For Echocardiographic Assessment of Left Ventricular Function. Malaysian Journal of Medical Sciences, Vol. 11, No. 1, January 2004, pp. 66-74
Jump up ^ Schneider, Michel (1999). "Characteristics of SonoVue™". Echocardiography. 16 (7, Pt 2): 743–746. doi:10.1111/j.1540-8175.1999.tb00144.x. PMID 11175217.
Jump up ^ Gramiak, Raymond; Shah, Pravin M. (1968). "Echocardiography of the Aortic Root". Investigative Radiology. 3 (5): 356–66. doi:10.1097/00004424-196809000-00011. PMID 5688346.
Jump up ^ "CEUS Around the World – The International Contrast Ultrasound Society (ICUS)" (PDF). October 2013. Archived from the original (PDF) on October 29, 2013. Retrieved 2013-10-27.
Jump up ^ Claudon, Michel; Dietrich, Christoph F.; Choi, Byung Ihn; Cosgrove, David O.; Kudo, Masatoshi; Nolsøe, Christian P.; Piscaglia, Fabio; Wilson, Stephanie R.; Barr, Richard G.; Chammas, Maria C.; Chaubal, Nitin G.; Chen, Min-Hua; Clevert, Dirk Andre; Correas, Jean Michel; Ding, Hong; Forsberg, Flemming; Fowlkes, J. Brian; Gibson, Robert N.; Goldberg, Barry B.; Lassau, Nathalie; Leen, Edward L.S.; Mattrey, Robert F.; Moriyasu, Fuminori; Solbiati, Luigi; Weskott, Hans-Peter; Xu, Hui-Xiong; World Federation for Ultrasound in Medicine; European Federation of Societies for Ultrasound (2013). "Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012". Ultrasound in Medicine & Biology. 39 (2): 187–210. doi:10.1016/j.ultrasmedbio.2012.09.002. PMID 23137926.
Jump up ^ Piscaglia, F.; Nolsøe, C.; Dietrich, C.; Cosgrove, D.; Gilja, O.; Bachmann Nielsen, M.; Albrecht, T.; Barozzi, L.; Bertolotto, M.; Catalano, O.; Claudon, M.; Clevert, D.; Correas, J.; d'Onofrio, M.; Drudi, F.; Eyding, J.; Giovannini, M.; Hocke, M.; Ignee, A.; Jung, E.; Klauser, A.; Lassau, N.; Leen, E.; Mathis, G.; Saftoiu, A.; Seidel, G.; Sidhu, P.; Ter Haar, G.; Timmerman, D.; Weskott, H. (2011). "The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications". Ultraschall in der Medizin. 33 (1): 33–59. doi:10.1055/s-0031-1281676. PMID 21874631.
Jump up ^ Tang, M.- X.; Mulvana, H.; Gauthier, T.; Lim, A. K. P.; Cosgrove, D. O.; Eckersley, R. J.; Stride, E. (2011). "Quantitative contrast-enhanced ultrasound imaging: A review of sources of variability". Interface Focus. 1 (4): 520–39. doi:10.1098/rsfs.2011.0026. PMC 3262271  . PMID 22866229.
Jump up ^ Lassau, N.; Koscielny, S.; Chami, L.; Chebil, M.; Benatsou, B.; Roche, A.; Ducreux, M.; Malka, D.; Boige, V. (2010). "Advanced Hepatocellular Carcinoma: Early Evaluation of Response to Bevacizumab Therapy at Dynamic Contrast-enhanced US with Quantification—Preliminary Results". Radiology. 258 (1): 291–300. doi:10.1148/radiol.10091870. PMID 20980447.
Jump up ^ Sugimoto, Katsutoshi; Moriyasu, Fuminori; Saito, Kazuhiro; Rognin, Nicolas; Kamiyama, Naohisa; Furuichi, Yoshihiro; Imai, Yasuharu (2013). "Hepatocellular carcinoma treated with sorafenib: Early detection of treatment response and major adverse events by contrast-enhanced US". Liver International. 33 (4): 605–15. doi:10.1111/liv.12098. PMID 23305331.
Jump up ^ Rognin, N G; Arditi, M; Mercier, L; Frinking, P J A; Schneider, M; Perrenoud, G; Anaye, A; Meuwly, J; Tranquart, F (2010). "Parametric imaging for characterizing focal liver lesions in contrast-enhanced ultrasound". IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. 57 (11): 2503–11. doi:10.1109/TUFFC.2010.1716. PMID 21041137.
Jump up ^ Rognin N, et al. (2010). "Parametric images based on dynamic behavior over time". International Patent. World Intellectual Property Organization (WIPO). pp. 1–44.
Jump up ^ Tranquart, F.; Mercier, L.; Frinking, P.; Gaud, E.; Arditi, M. (2012). "Perfusion Quantification in Contrast-Enhanced Ultrasound (CEUS) – Ready for Research Projects and Routine Clinical Use". Ultraschall in der Medizin. 33: S31–8. doi:10.1055/s-0032-1312894. PMID 22723027.
Jump up ^ Angelelli, Paolo; Nylund, Kim; Gilja, Odd Helge; Hauser, Helwig (2011). "Interactive visual analysis of contrast-enhanced ultrasound data based on small neighborhood statistics". Computers & Graphics. 35 (2): 218–226. doi:10.1016/j.cag.2010.12.005.
Jump up ^ Barnes E, Contrast US processing tool shows malignant liver lesions, AuntMinnie.com, 2010.
Jump up ^ Anaye, A.; Perrenoud, G.; Rognin, N.; Arditi, M.; Mercier, L.; Frinking, P.; Ruffieux, C.; Peetrons, P.; Meuli, R.; Meuwly, J.-Y. (2011). "Differentiation of Focal Liver Lesions: Usefulness of Parametric Imaging with Contrast-enhanced US". Radiology. 261 (1): 300–10. doi:10.1148/radiol.11101866. PMID 21746815.
Jump up ^ Yuan, Zhang; Quan, Jiang; Yunxiao, Zhang; Jian, Chen; Zhu, He; Liping, Gong (2013). "Diagnostic Value of Contrast-Enhanced Ultrasound Parametric Imaging in Breast Tumors". Journal of Breast Cancer. 16 (2): 208–13. doi:10.4048/jbc.2013.16.2.208. PMC 3706868  . PMID 23843855.
Jump up ^ Klibanov, A. L.; Hughes, M. S.; Marsh, J. N.; Hall, C. S.; Miller, J. G.; Wilble, J. H.; Brandenburger, G. H. (1997). "Targeting of ultrasound contrast material. An in vitro feasibility study". Acta Radiologica Supplementum. 412: 113–120. PMID 9240089.
Jump up ^ Klibanov, A (1999). "Targeted delivery of gas-filled microspheres, contrast agents for ultrasound imaging". Advanced Drug Delivery Reviews. 37 (1–3): 139–157. doi:10.1016/S0169-409X(98)00104-5. PMID 10837732.
Jump up ^ Pochon, S; Tardy, I; Bussat, P; Bettinger, T; Brochot, J; Von Wronski, M; Passantino, L; Schneider, M (2010). "BR55: A lipopeptide-based VEGFR2-targeted ultrasound contrast agent for molecular imaging of angiogenesis". Investigative radiology. 45 (2): 89–95. doi:10.1097/RLI.0b013e3181c5927c. PMID 20027118.
Jump up ^ Willmann, J. K.; Kimura, R. H.; Deshpande, N.; Lutz, A. M.; Cochran, J. R.; Gambhir, S. S. (2010). "Targeted Contrast-Enhanced Ultrasound Imaging of Tumor Angiogenesis with Contrast Microbubbles Conjugated to Integrin-Binding Knottin Peptides". Journal of Nuclear Medicine. 51 (3): 433–40. doi:10.2967/jnumed.109.068007. PMC 4111897  . PMID 20150258.
Jump up ^ Lindner, JR (2004). "Molecular imaging with contrast ultrasound and targeted microbubbles". Journal of Nuclear Cardiology. 11 (2): 215–21. doi:10.1016/j.nuclcard.2004.01.003. PMID 15052252.
Jump up ^ Clinical trial number NCT01253213 for "BR55 in Prostate Cancer: an Exploratory Clinical Trial" at ClinicalTrials.gov
Jump up ^ Dayton, Paul; Klibanov, Alexander; Brandenburger, Gary; Ferrara, Kathy (1999). "Acoustic radiation force in vivo: A mechanism to assist targeting of microbubbles". Ultrasound in Medicine & Biology. 25 (8): 1195–1201. doi:10.1016/S0301-5629(99)00062-9. PMID 10576262.
Jump up ^ Frinking, Peter J.A.; Tardy, Isabelle; Théraulaz, Martine; Arditi, Marcel; Powers, Jeffry; Pochon, Sibylle; Tranquart, François (2012). "Effects of Acoustic Radiation Force on the Binding Efficiency of BR55, a VEGFR2-Specific Ultrasound Contrast Agent". Ultrasound in Medicine & Biology. 38 (8): 1460–9. doi:10.1016/j.ultrasmedbio.2012.03.018. PMID 22579540.
Jump up ^ Gessner, Ryan C.; Streeter, Jason E.; Kothadia, Roshni; Feingold, Steven; Dayton, Paul A. (2012). "An In Vivo Validation of the Application of Acoustic Radiation Force to Enhance the Diagnostic Utility of Molecular Imaging Using 3-D Ultrasound". Ultrasound in Medicine & Biology. 38 (4): 651–60. doi:10.1016/j.ultrasmedbio.2011.12.005. PMC 3355521  . PMID 22341052.
Jump up ^ Rognin N; et al. (2013). "Molecular Ultrasound Imaging Enhancement by Volumic Acoustic Radiation Force (VARF): Pre-clinical in vivo Validation in a Murine Tumor Model". World Molecular Imaging Congress, Savannah, GA, USA. Archived from the original on October 11, 2013.
^ Jump up to: a b Wells P. N. T. (2011). "Medical ultrasound: imaging of soft tissue strain and elasticity". Journal of the Royal Society, Interface. 8 (64): 1521–1549. doi:10.1098/rsif.2011.0054. PMC 3177611  .
^ Jump up to: a b c Sarvazyan A, Hall TJ, Urban MW, Fatemi M, Aglyamov SR, Garra BS (2011). "Overview of elastography–an emerging branch of medical imaging". Current medical imaging reviews. 7 (4): 255–282. doi:10.2174/157340511798038684. PMC 3269947  . PMID 22308105.
Jump up ^ Ophir, J.; Céspides, I.; Ponnekanti, H.; Li, X. (1991). "Elastography: A quantitative method for imaging the elasticity of biological tissues". Ultrasonic Imaging. 13 (2): 111–34. doi:10.1016/0161-7346(91)90079-W. PMID 1858217.
Jump up ^ Parker, K J; Doyley, M M; Rubens, D J (2012). "Corrigendum: Imaging the elastic properties of tissue: The 20 year perspective". Physics in Medicine and Biology. 57 (16): 5359–5360. Bibcode:2012PMB....57.5359P. doi:10.1088/0031-9155/57/16/5359.
Jump up ^ Cogo, A.; Lensing, A. W A; Koopman, M. M W; Piovella, F.; Siragusa, S.; Wells, P. S; Villalta, S.; Büller, H. R; Turpie, A. G G; Prandoni, P. (1998). "Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: Prospective cohort study". BMJ. 316 (7124): 17–20. doi:10.1136/bmj.316.7124.17. PMC 2665362  . PMID 9451260.
Jump up ^ Kearon, Clive; Julian, JA; Newman, TE; Ginsberg, JS (1998). "Noninvasive Diagnosis of Deep Venous Thrombosis". Annals of Internal Medicine. 128 (8): 663–77. doi:10.7326/0003-4819-128-8-199804150-00011. PMID 9537941.
Jump up ^ Jongbloets, L.M.M.; Koopman, M.M.W.; Büller, H.R.; Ten Cate, J.W.; Lensing, A.W.A. (1994). "Limitations of compression ultrasound for the detection of symptomless postoperative deep vein thrombosis". The Lancet. 343 (8906): 1142–4. doi:10.1016/S0140-6736(94)90240-2. PMID 7910237.
Jump up ^ Reddan, Tristan; Corness, Jonathan; Mengersen, Kerrie; Harden, Fiona (March 2016). "Ultrasound of paediatric appendicitis and its secondary sonographic signs: providing a more meaningful finding". Journal of Medical Radiation Sciences. 63 (1): 59–66. doi:10.1002/jmrs.154.
Jump up ^ Llamas-Álvarez, AM; Tenza-Lozano, EM; Latour-Pérez, J (February 2017). "Accuracy of Lung Ultrasonography in the Diagnosis of Pneumonia in Adults: Systematic Review and Meta-Analysis". Chest. 151 (2): 374–382. doi:10.1016/j.chest.2016.10.039. PMID 27818332.
Jump up ^ Merritt, CR (1989). "Ultrasound safety: What are the issues?". Radiology. 173 (2): 304–6. doi:10.1148/radiology.173.2.2678243. PMID 2678243. [dead link]
Jump up ^ "Training in Diagnostic Ultrasound: essentials, principles and standards" (PDF). WHO. 1998. p. 2.
Jump up ^ American Academy of Orthopaedic Surgeons (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Orthopaedic Surgeons, retrieved 19 May 2013 , which cites
Members of 2007 and 2011 AAOS Guideline Development Work Groups on PE/VTED Prophylaxis; Mont, M; Jacobs, J; Lieberman, J; Parvizi, J; Lachiewicz, P; Johanson, N; Watters, W (Apr 18, 2012). "Preventing venous thromboembolic disease in patients undergoing elective total hip and knee arthroplasty". The Journal of Bone and Joint Surgery. American Volume. 94 (8): 673–4. doi:10.2106/JBJS.9408edit. PMC 3326687  . PMID 22517384.
Jump up ^ Lockwook, Charles J. "Keepsake fetal ultrasounds (November 01, 2010)". Modern Medicine Network. Retrieved 11 September 2017.
Jump up ^ Bricker, L; Garcia, J; Henderson, J; Mugford, M; Neilson, J; Roberts, T; Martin, MA (2000). "Ultrasound screening in pregnancy: A systematic review of the clinical effectiveness, cost-effectiveness and women's views". Health technology assessment. 4 (16): i–vi, 1–193. PMID 11070816.
Jump up ^ Ang, E. S. B. C.; Gluncic, V.; Duque, A.; Schafer, M. E.; Rakic, P. (2006). "Prenatal exposure to ultrasound waves impacts neuronal migration in mice". Proceedings of the National Academy of Sciences. 103 (34): 12903–10. Bibcode:2006PNAS..10312903A. doi:10.1073/pnas.0605294103. PMC 1538990  . PMID 16901978. [non-primary source needed]
Jump up ^ Kieler, Helle; Cnattingius, Sven; Haglund, Bengt; Palmgren, Juni; Axelsson, Ove (2001). "Sinistrality—a side-effect of prenatal sonography: A comparative study of young men". Epidemiology. 12 (6): 618–23. doi:10.1097/00001648-200111000-00007. PMID 11679787. [non-primary source needed]
Jump up ^ Salvesen, K A; Vatten, L J; Eik-Nes, S H; Hugdahl, K; Bakketeig, L S (1993). "Routine ultrasonography in utero and subsequent handedness and neurological development". BMJ. 307 (6897): 159–64. doi:10.1136/bmj.307.6897.159. PMC 1678377  . PMID 7688253. [non-primary source needed]
Jump up ^ Kieler, Helle; Axelsson, Ove; Haglund, Bengt; Nilsson, Staffan; Salvesen, Kjell Å. (1998). "Routine ultrasound screening in pregnancy and the children's subsequent handedness". Early Human Development. 50 (2): 233–45. doi:10.1016/S0378-3782(97)00097-2. PMID 9483394. [non-primary source needed]
Jump up ^ Heikkilä, K.; Vuoksimaa, E.; Oksava, K.; Saari-Kemppainen, A.; Iivanainen, M. (2011). "Handedness in the Helsinki Ultrasound Trial". Ultrasound in Obstetrics & Gynecology. 37 (6): 638–642. doi:10.1002/uog.8962. [non-primary source needed]
Jump up ^ Salvesen, K. Å. (2011). "Ultrasound in pregnancy and non-right handedness: Meta-analysis of randomized trials". Ultrasound in Obstetrics & Gynecology. 38 (3): 267–271. doi:10.1002/uog.9055.
Jump up ^ Legislation. ardms.org
Jump up ^ Deane, Collin (2002). "Safety of diagnostic ultrasound in fetal scanning". In Kypros Nicolaides; Giuseppe Rizzo; Kurt Hecker; Renato Ximenes. Doppler in Obstetrics.
Jump up ^ MTP and PCPNDT Initiatives Report Archived 2014-06-01 at the Wayback Machine. Government of India (2011)
Jump up ^ IMPLEMENTATION OF THE PCPNDT ACT IN INDIA – Perspectives and Challenges. Public Health Foundation of India, Supported by United Nations FPA (2010)
Jump up ^ "THE PRE-NATAL DIAGNOSTIC TECHNIQUES (REGULATION AND PREVENTION OF MISUSE) ACT, 1994". mohfw.nic.in. 20 September 1994. Archived from the original on 24 January 2005.
Jump up ^ Siddharth, S.; Goyal, A. (2007). "The origin of echocardiography". Texas Heart Institute Journal. 34 (4): 431–438. PMC 2170493  . PMID 18172524.
Jump up ^ Levine, H. III. (2010). Medical Imaging. Santa Barbara, California: ABC-CLIO, LLC., p. 62, describing earlier not completely successful attempt by the brothers to image a brain in 1937, which may be the same experiment
Jump up ^ "History of the AIUM". Archived from the original on November 3, 2005. Retrieved November 15, 2005.
Jump up ^ "The History of Ultrasound: A collection of recollections, articles, interviews and images". www.obgyn.net. Archived from the original on 5 August 2006. Retrieved 2006-05-11.
Jump up ^ Watts, G. (2009). "John Wild". BMJ. 339: b4428. doi:10.1136/bmj.b4428.
Jump up ^ Tilli Tansey; Daphne Christie, eds. (2000), Looking at the Unborn: Historical aspects of obstetric ultrasound, Wellcome Witnesses to Contemporary Medicine, History of Modern Biomedicine Research Group, ISBN 978-1-84129-011-9 , Wikidata Q29581634
Jump up ^ Looking at the Unborn: Historical aspects of obstetric ultrasound. History of Modern Biomedicine Research Group. 2000. ISBN 978-1-84129-011-9.
Jump up ^ Donald, Ian; MacVicar, J; Brown, T.G (1958). "Investigation of Abdominal Masses by Pulsed Ultrasound". The Lancet. 271 (7032): 1188–95. doi:10.1016/S0140-6736(58)91905-6. PMID 13550965.
Jump up ^ Edler, I.; Hertz, C. H. (2004). "The Use of Ultrasonic Reflectoscope for the Continuous Recording of the Movements of Heart Walls". Clinical Physiology and Functional Imaging. 24 (3): 118–36. doi:10.1111/j.1475-097X.2004.00539.x. PMID 15165281.
Jump up ^ Woo, Joseph (2002). "A short History of the development of Ultrasound in Obstetrics and Gynecology". ob-ultrasound.net. Retrieved 2007-08-26.
Jump up ^ Zierler, R. Eugene (2002). "D. Eugene Strandness, Jr, MD, 1928–2002". Journal of Ultrasound. 21 (11): 1323–1325. doi:10.1067/mva.2002.123028.
Jump up ^ Medical Imaging Past Present and Future: 2 ARRT category A continuing education credits are available by way of an online post test at XRayCeRT.com. XRayCeRT. GGKEY:6WU7UCYWQS7.
Jump up ^ "Portable Ultrasound Equipment Market 2017 Global Leading Players Analysis & Industry Forecast to 2022". Retrieved 29 December 2017.
External links[edit]
Wikimedia Commons has media related to Medical ultrasound.
About the discovery of medical ultrasonography on ob-ultrasound.net
History of medical sonography (ultrasound) on ob-ultrasound.net
hide
v
t
e
Medical imaging (ICD-9-CM V3 87–88, ICD-10-PCS B, CPT 70010–79999)
X-ray/
Radiography
2D
Medical:
Pneumoencephalography
Dental radiography
Sialography
Myelography
CXR
Bronchography
AXR
KUB
DXA/DXR
Upper gastrointestinal series/Small-bowel follow-through/Lower gastrointestinal series
Cholangiography/Cholecystography
Mammography
Pyelogram
Cystography
Arthrogram
Hysterosalpingography
Skeletal survey
Angiography
Angiocardiography
Aortography
Venography
Lymphogram
Industrial:
Radiographic testing
CT scan
Techniques:
General operation of CT
Quantitative CT
High resolution CT
X-ray microtomography
Electron beam tomography
Targets
Coronary
Calcium scan
CT angiography
Abdominal and pelvic CT
Virtual colonoscopy
CT angiography
Coronary CT
Pulmonary CT
Head CT
Thyroid CT
Whole body imaging
Full-body CT scan
Other
Fluoroscopy
Dental panoramic radiography
X-ray motion analysis
MRI
MRI of the brain
MR neurography
Cardiac MRI/Cardiac MRI perfusion
MR angiography
MR cholangiopancreatography
Breast MRI
Functional MRI
Sequences
Diffusion MRI
Perfusion MRI
Tractography
Synthetic MRI
Ultrasound
Echocardiography
Doppler ultrasonography
Doppler echocardiography
TTE
TEE
Transcranial Doppler
Intravascular
Gynecologic
Obstetric
Echoencephalography
Abdominal ultrasonography
Transrectal
Breast ultrasound
Transscrotal ultrasound
Carotid ultrasonography
Contrast-enhanced
3D ultrasound
Endoscopic ultrasound
Emergency ultrasound
FAST
Pre-hospital ultrasound
Duplex
Radionuclide
2D / scintigraphy
Cholescintigraphy
Scintimammography
Ventilation/perfusion scan
Radionuclide ventriculography
Radionuclide angiography
Radioisotope renography
Sestamibi parathyroid scintigraphy
Radioactive iodine uptake test
Bone scintigraphy
Immunoscintigraphy
Dacryoscintigraphy
DMSA scan
Gastric emptying scan
Full body:
Octreotide scan
Gallium 67 scan
Indium-111 WBC scan
3D / ECT
SPECT (gamma ray):
Myocardial perfusion imaging
PET (positron):
Brain PET
Cardiac PET
PET mammography
PET-CT
PET-MRI
Optical/Laser
Optical tomography
Optical coherence tomography
Confocal microscopy
Endomicroscopy
Orthogonal polarization spectral imaging
Thermography
non-contact thermography
contact thermography
dynamic angiothermography
Authority control
BNF: cb11931925j (data)
GND: 4248514-9
NDL: 01003919
Retrieved from "https://en.wikipedia.org/w/index.php?title=Medical_ultrasound&oldid=856972569"
Categories:
Medical imaging
Acoustics
Medical equipment
Medical ultrasonography
Physical therapy
Hidden categories:
CS1 maint: Multiple names: authors list
All articles with dead external links
Articles with dead external links from August 2018
Articles with permanently dead external links
Webarchive template wayback links
Wikipedia articles needing page number citations from November 2013
Articles with dead external links from May 2015
All pages needing factual verification
Wikipedia articles needing factual verification from April 2013
All articles with unsourced statements
Articles with unsourced statements from April 2016
Wikipedia articles with BNF identifiers
Wikipedia articles with GND identifiers
Wikipedia articles with NDL identifiers
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
In other projects
Wikimedia Commons
Languages
العربية
Български
Català
Čeština
Dansk
Deutsch
Ελληνικά
Español
Esperanto
Euskara
فارسی
Français
Gaeilge
Galego
ગુજરાતી
한국어
Հայերեն
हिन्दी
Bahasa Indonesia
Italiano
עברית
Basa Jawa
ಕನ್ನಡ
Lietuvių
Magyar
മലയാളം
मराठी
Nederlands
日本語
Norsk
پنجابی
Polski
Português
Română
Русский
Simple English
Slovenčina
Slovenščina
کوردی
Српски / srpski
Svenska
தமிழ்
తెలుగు
ไทย
Türkçe
Українська
اردو
Tiếng Việt
中文
40 more
Edit links
This page was last edited on 28 August 2018, at 18:31 (UTC).
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

key: html

type: local

value: div

attrs: id class

values: mw-page-base noprint

values: mw-head-base noprint

value: a

attrs: id class lang

values: firstHeading firstHeading en

values: siteSub noprint

attrs: class href

values: mw-jump-link #mw-head

values: mw-jump-link #p-search

attrs: href title

attrs: role class

values:
note
hatnote navigation-not-searchable

value: th

attrs: colspan style

value: img

attrs: alt src width height srcset data-file-width data-file-height

values: Sonographer doing pediatric echocardiography.JPG

attrs: href class

values:
/wiki/Ultrasound_transducer
mw-redirect
Ultrasound transducer

values:
/wiki/Doppler_ultrasound
mw-redirect
Doppler ultrasound

values: checkbox button toctogglecheckbox toctogglecheckbox display:none

attrs: alt src width height class srcset data-file-width data-file-height

values:
/wiki/Duplex_ultrasound
mw-redirect
Duplex ultrasound

values:
/wiki/Piezoelectric_transducer
mw-redirect
Piezoelectric transducer

values: Capacitive micromachined ultrasonic transducers

values: Ultrasonography of deep venous thrombosis

values: Ultrasonography of chronic venous insufficiency of the legs

values: Focused assessment with sonography for trauma

values:
/wiki/Pericardial_tamponade
mw-redirect
Pericardial tamponade

values:
/wiki/Physical_trauma
mw-redirect
Physical trauma

values: Edit section: Gastroenterology/Colorectal surgery

values:
/wiki/Gall_bladder
mw-redirect
Gall bladder

values:
/wiki/Vermiform_appendix
mw-redirect
Vermiform appendix

values:
/wiki/Fallopian_tubes
mw-redirect
Fallopian tubes

values:
/wiki/Adnexa_of_uterus
mw-redirect
Adnexa of uterus

values:
/wiki/Pouch_of_Douglas
mw-redirect
Pouch of Douglas

values:
/wiki/Obstetrical_ultrasonography
mw-redirect
Obstetrical ultrasonography

values:
/wiki/Multiple_pregnancy
mw-redirect
Multiple pregnancy

values:
/wiki/Doppler_sonography
mw-redirect
Doppler sonography

values: Edit section: Otolaryngology (head and neck)

values:
/wiki/Lymph_nodes
mw-redirect
Lymph nodes

values:
/wiki/Salivary_glands
mw-redirect
Salivary glands

values:
/wiki/B-mode_imaging
mw-redirect
B-mode imaging

values:
/wiki/Echo_(phenomenon)
mw-redirect
Echo (phenomenon)

values:
/wiki/Ultrasonic_sensor
mw-redirect
Ultrasonic sensor

values: vertical-align: -2.171ex; width:18.535ex; height:5.176ex;

values: \textstyle 0.5 \frac{\mbox{dB}}{\mbox{cm depth}\cdot\mbox{MHz}}

values: File:B-flow ultrasonography of venous reflux.gif

values:
/wiki/Duplex_ultrasonography
mw-redirect
Duplex ultrasonography

values:
/wiki/Cardiac_valve
mw-redirect
Cardiac valve

values:
/wiki/Valvular_regurgitation
mw-redirect
Valvular regurgitation

values:
/wiki/Diastolic_dysfunction
mw-redirect
Diastolic dysfunction

values:
/wiki/Fetal_heartbeat
mw-redirect
Fetal heartbeat

values:
/wiki/Fetal_stethoscope
mw-redirect
Fetal stethoscope

values: Edit section: Contrast ultrasonography (ultrasound contrast imaging)

values:
/wiki/Contrast_media
mw-redirect
Contrast media

values:
/wiki/Blood_stream
mw-redirect
Blood stream

values:
/wiki/Blood_vessels
mw-redirect
Blood vessels

values:
/wiki/Interstitial_fluid
mw-redirect
Interstitial fluid

values:
/wiki/Left_ventricle
mw-redirect
Left ventricle

values:
/wiki/Malignant_tumor
mw-redirect
Malignant tumor

values: Edit section: Molecular ultrasonography (ultrasound molecular imaging)

values: Edit section: Elastography (ultrasound elasticity imaging)

values: Edit section: Interventional ultrasonography

values:
/wiki/Thyroid_cyst
mw-redirect
Thyroid cyst

values: Edit section: Compression ultrasonography

values:
/wiki/X-ray_computed_tomography
mw-redirect
X-ray computed tomography

values:
/wiki/Dual_energy_X-ray_absorptiometry
mw-redirect
Dual energy X-ray absorptiometry

values: Edit section: Studies on the safety of ultrasound

values: American Registry for Diagnostic Medical Sonography

values: Cardiovascular Credentialing International (page does not exist)

values: American Registry of Radiologic Technologists (page does not exist)

values: This claim needs references to reliable sources. (April 2016)

values:
noprint Inline-Template Template-Fact
white-space:nowrap;

values:
/wiki/Mechanical_Index
mw-redirect
Mechanical Index

values: Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994

values: Thomas Brown (medical physicist) (page does not exist)

values: "Thomas Brown (medical physicist)" in other languages

values:
noprint
font-size:85%; font-style: normal;

values: Stuart Campbell (Obstetrician and Gynaecologist)

values: Hector M. Garcia-Garcia (page does not exist)

values: Patrick W. Serruys (page does not exist)

values: The international journal of cardiovascular imaging (page does not exist)

values:
/wiki/PubMed_Identifier
mw-redirect
PubMed Identifier

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/21327914

values: Category:CS1 maint: Multiple names: authors list

values:
nofollow
external text
//doi.org/10.5772/31137

values:
nofollow
external text
//doi.org/10.1136/thx.2005.047829

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/16738038

values: This citation requires a reference to the specific page or range of pages in which the material appears. (November 2013)

values:
nofollow
external text
//doi.org/10.1097/WNP.0000000000000245

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/27035250

values:
nofollow
external text
//doi.org/10.3389/fnagi.2014.00172

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/25071570

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/25444689

values:
nofollow
external text
//doi.org/10.1186/2046-2395-3-9

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/25520782

values:
nofollow
external text
//doi.org/10.2147/CIA.S47263

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/23926426

values:
nofollow
external text
//doi.org/10.3389/fphys.2015.00302

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/26578974

values:
nofollow
external text
//doi.org/10.3390/diagnostics6010002

values:
nofollow
external text
//www.worldcat.org/issn/2075-4418

values:
nofollow
external text
//www.worldcat.org/issn/0929-6441

values:
nofollow
external text
//doi.org/10.2214/AJR.06.1161

values:
nofollow
external text
//www.worldcat.org/issn/0361-803X

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/11175217

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/5688346

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/23137926

values:
nofollow
external text
//doi.org/10.1055/s-0031-1281676

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/21874631

values:
nofollow
external text
//doi.org/10.1098/rsfs.2011.0026

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22866229

values:
nofollow
external text
//doi.org/10.1148/radiol.10091870

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/20980447

values:
nofollow
external text
//doi.org/10.1111/liv.12098

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/23305331

values:
nofollow
external text
//doi.org/10.1109/TUFFC.2010.1716

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/21041137

values:
nofollow
external text
//doi.org/10.1055/s-0032-1312894

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22723027

values:
nofollow
external text
//doi.org/10.1016/j.cag.2010.12.005

values:
nofollow
external text
//doi.org/10.1148/radiol.11101866

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/21746815

values:
nofollow
external text
//doi.org/10.4048/jbc.2013.16.2.208

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/23843855

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/9240089

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/10837732

values:
nofollow
external text
//doi.org/10.1097/RLI.0b013e3181c5927c

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/20027118

values:
nofollow
external text
//doi.org/10.2967/jnumed.109.068007

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/20150258

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/15052252

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/10576262

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22579540

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22341052

values:
nofollow
external text
//doi.org/10.1098/rsif.2011.0054

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22308105

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/1858217

values:
nofollow
external text
//doi.org/10.1136/bmj.316.7124.17

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/9451260

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/9537941

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/7910237

values:
nofollow
external text
//doi.org/10.1002/jmrs.154

values:
nofollow
external text
//doi.org/10.1016/j.chest.2016.10.039

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/27818332

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/2678243

values: American Academy of Orthopaedic Surgeons

values:
/wiki/ABIM_Foundation
mw-redirect
ABIM Foundation

values:
nofollow
external text
//doi.org/10.2106/JBJS.9408edit

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/22517384

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/11070816

values:
nofollow
external text
//doi.org/10.1073/pnas.0605294103

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/16901978

values: This claim needs references to reliable secondary sources. (April 2013)

values: noprint Inline-Template noprint Template-Fact

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/11679787

values:
nofollow
external text
//doi.org/10.1136/bmj.307.6897.159

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/7688253

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/9483394

values:
nofollow
external text
//doi.org/10.1002/uog.8962

values:
nofollow
external text
//doi.org/10.1002/uog.9055

values:
nofollow
external text
http://jskvrc.gov.in/ipas/2.pdf

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/18172524

values:
nofollow
external text
//doi.org/10.1136/bmj.b4428

values: History of Modern Biomedicine Research Group

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/13550965

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/15165281

values:
nofollow
external text
//doi.org/10.1067/mva.2002.123028

values: -moz-column-width: 30em; -webkit-column-width: 30em; column-width: 30em; list-style-type: decimal;

values:
/wiki/Small-bowel_follow-through
mw-redirect
Small-bowel follow-through

values:
/wiki/Radiographic_testing
mw-redirect
Radiographic testing

values:
/wiki/High_resolution_CT
mw-redirect
High resolution CT

values: Computed tomography of the abdomen and pelvis

values:
/wiki/Cardiac_MRI_perfusion
mw-redirect
Cardiac MRI perfusion

values:
/wiki/Medical_ultrasonography
mw-redirect
Medical ultrasonography

values:
/wiki/Transscrotal_ultrasound
mw-redirect
Transscrotal ultrasound

values:
/wiki/Gallium_67_scan
mw-redirect
Gallium 67 scan

values: Single-photon emission computed tomography

values: Positron emission tomography–magnetic resonance imaging

values:
/wiki/Optical_imaging
mw-redirect
Optical imaging

values: Orthogonal polarization spectral imaging

values: Contact thermography (page does not exist)

values: nowraplinks hlist collapsible autocollapse navbox-inner mw-collapsible mw-made-collapsible

attrs: alt src width height style srcset data-file-width data-file-height

values:
nofollow
external text
https://d-nb.info/gnd/4248514-9

values: Category:All articles with dead external links

values: Category:Articles with dead external links from August 2018

values: Category:Articles with permanently dead external links

values: Category:Webarchive template wayback links

values: Category:Wikipedia articles needing page number citations from November 2013

values: Category:Articles with dead external links from May 2015

values: Category:All pages needing factual verification

values: Category:Wikipedia articles needing factual verification from April 2013

values: Category:All articles with unsourced statements

values: Category:Articles with unsourced statements from April 2016

values: Category:Wikipedia articles with BNF identifiers

values: Category:Wikipedia articles with GND identifiers

values: Category:Wikipedia articles with NDL identifiers

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values:
/wiki/Medical_ultrasound
View the content page [ctrl-alt-c]
c

values: Discussion about the content page [ctrl-alt-t]

values: p-namespaces navigation vectorTabs p-namespaces-label

values:
p-variants
navigation
vectorMenu emptyPortlet
p-variants-label

values: Past revisions of this page [ctrl-alt-h]

values: p-views navigation vectorTabs p-views-label

values:
p-cactions
navigation
vectorMenu emptyPortlet
p-cactions-label

values:
mw-wiki-logo
/wiki/Main_Page
Visit the main page

values:
/wiki/Main_Page
Visit the main page [ctrl-alt-z]
z

values: Featured content – the best of Wikipedia

values: Find background information on current events

values:
/wiki/Special:Random
Load a random article [ctrl-alt-x]
x

values: portal navigation p-navigation p-navigation-label

values: Guidance on how to use and edit Wikipedia

values: About the project, what you can do, where to find things

values: A list of recent changes in the wiki [ctrl-alt-r]

values: portal navigation p-interaction p-interaction-label

values: List of all English Wikipedia pages containing links to this page [ctrl-alt-j]

values: Recent changes in pages linked from this page [ctrl-alt-k]

values:
/wiki/Wikipedia:File_Upload_Wizard
Upload files [ctrl-alt-u]
u

values: A list of all special pages [ctrl-alt-q]

values: Permanent link to this revision of the page

values: Link to connected data repository item [ctrl-alt-g]

values: Printable version of this page [ctrl-alt-p]

values: portal navigation p-wikibase-otherprojects p-wikibase-otherprojects-label

values: تخطيط الصدى الطبي – Arabic

values: Ехография – Bulgarian

values:
interlanguage-link interwiki-bg
display: none;

values:
https://ca.wikipedia.org/wiki/Ecografia
Ecografia – Catalan
ca
ca
interlanguage-link-target

values:
interlanguage-link interwiki-ca
display: none;

values:
interlanguage-link interwiki-cs
display: none;

values:
interlanguage-link interwiki-da
display: none;

values: interlanguage-link interwiki-de badge-Q17437796 badge-featuredarticle

values: Υπερηχοτομογραφία – Greek

values:
interlanguage-link interwiki-el
display: none;

values:
interlanguage-link interwiki-eo
display: none;

values:
https://eu.wikipedia.org/wiki/Ekografia
Ekografia – Basque
eu
eu
interlanguage-link-target

values:
interlanguage-link interwiki-eu
display: none;

values: سونوگرافی – Persian

values:
interlanguage-link interwiki-fa
display: none;

values:
interlanguage-link interwiki-fr
display: none;

values:
interlanguage-link interwiki-ga
display: none;

values:
interlanguage-link interwiki-gl
display: none;

values: સોનોગ્રાફી પરીક્ષણ – Gujarati

values:
interlanguage-link interwiki-gu
display: none;

values: 의료 초음파 – Korean

values:
interlanguage-link interwiki-ko
display: none;

values: Ուլտրաձայնային հաստոց – Armenian

values:
interlanguage-link interwiki-hy
display: none;

values: सोनोग्राफी – Hindi

values:
https://it.wikipedia.org/wiki/Ecografia
Ecografia – Italian
it
it
interlanguage-link-target

values:
interlanguage-link interwiki-it
display: none;

values: בדיקת אולטרה סאונד רפואית – Hebrew

values:
interlanguage-link interwiki-he
display: none;

values:
https://jv.wikipedia.org/wiki/Ekografi
Ekografi – Javanese
jv
jv
interlanguage-link-target

values:
interlanguage-link interwiki-jv
display: none;

values: ವೈದ್ಯಕೀಯ ಶ್ರವಣಾತೀತ ಧ್ವನಿಚಿತ್ರಣ – Kannada

values:
interlanguage-link interwiki-kn
display: none;

values:
interlanguage-link interwiki-lt
display: none;

values:
interlanguage-link interwiki-hu
display: none;

values: അൾട്രാ സൗണ്ട് വൈദ്യ പരിശോധന – Malayalam

values:
interlanguage-link interwiki-ml
display: none;

values: सोनोग्राफी – Marathi

values:
interlanguage-link interwiki-mr
display: none;

values:
interlanguage-link interwiki-nl
display: none;

values:
interlanguage-link interwiki-ja
display: none;

values:
interlanguage-link interwiki-no
display: none;

values: الٹراسونوگرافی – Western Punjabi

values:
interlanguage-link interwiki-pnb
display: none;

values:
interlanguage-link interwiki-pl
display: none;

values:
https://ro.wikipedia.org/wiki/Ecografie
Ecografie – Romanian
ro
ro
interlanguage-link-target

values:
interlanguage-link interwiki-ro
display: none;

values: Ультразвуковое исследование – Russian

values: Medical ultrasonography – Simple English

values:
interlanguage-link interwiki-simple
display: none;

values:
interlanguage-link interwiki-sk
display: none;

values:
interlanguage-link interwiki-sl
display: none;

values:
interlanguage-link interwiki-ckb
display: none;

values: Ултрасонографија – Serbian

values:
interlanguage-link interwiki-sr
display: none;

values:
https://sv.wikipedia.org/wiki/Sonografi
Sonografi – Swedish
sv
sv
interlanguage-link-target

values:
interlanguage-link interwiki-sv
display: none;

values: மீயொலி நோட்டம் – Tamil

values:
interlanguage-link interwiki-ta
display: none;

values: మెడికల్ అల్ట్రాసౌండ్ – Telugu

values:
interlanguage-link interwiki-te
display: none;

values: การบันทึกด้วยคลื่นเสียงความถี่สูงทางการแพทย์ – Thai

values:
interlanguage-link interwiki-th
display: none;

values:
interlanguage-link interwiki-tr
display: none;

values: Медична акустика – Ukrainian

values:
interlanguage-link interwiki-uk
display: none;

values: صوتی تخطیط – Urdu

values:
interlanguage-link interwiki-vi
display: none;

values: 医学超声检查 – Chinese

values: All languages (initial selection from common choices by you and others)

values: /static/images/wikimedia-button-1.5x.png 1.5x, /static/images/wikimedia-button-2x.png 2x

values: /static/images/poweredby_mediawiki_132x47.png 1.5x, /static/images/poweredby_mediawiki_176x62.png 2x

values:
suggestions
display: none; font-size: 13px;

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-Medical_ultrasound rootpage-Medical_ultrasound skin-vector action-view