What We Do: Ultrasound

Ultrasound imaging (sonography) uses high-frequency sound waves to view soft tissues such as muscles and internal organs.  Because ultrasound images are captured in real-time, they can show movement of the body’s internal organs as well as blood flowing through blood vessels.

In an ultrasound exam, a hand-held transducer is placed against the skin.  The transducer sends out high frequency sound waves that reflect off of body structures.  The returning sound waves, or echoes, are displayed as an image on a monitor.  The image is based on the frequency and strength (amplitude) of the sound signal and the time it takes to return from the patient to the transducer.  Unlike an x-ray, there is no ionizing radiation exposure with this test.

  • Endorectal ultrasound is applied in the management of fecal incontinence, rectal tumors and inflammatory perianal conditions.  In fecal incontinence, anal ultrasound will confirm the presence or absence of sphincter defects.  This will direct any operative intervention such as sphincter repair.  Ultrasound in rectal cancer allows staging of the tumor by assessing the depth of the invasion through the bowel wall and involvement of mesenteric nodes.  Such staging might influence the choice of operation and determine which patients might benefit from preoperative chemotherapy and radiotherapy.  Endorectal ultrasound has a particular role in recurrent and complex anal fistula and perianal sepsis.  Preoperative and perioperative planning with accurate delineation of fistula tracts, extensions and sphincter involvement might help prevent recurrence and impaired continence from sphincter damage after surgery.

  • Endovaginal ultrasound obtains detailed images of the uterus, endometrium (uterine lining) and ovaries.  This exam gives a clearer view of the pelvic organs and can help further assess any findings from the pelvic ultrasound.  Endovaginal ultrasound is the best test for diagnosing an ovarian cyst.  Using endovaginal ultrasound, the internal cystic structure may be categorized as simple (just fluid filled), complex (areas of fluid mixed with solid material), or completely solid (with no obvious fluid).

  • Abdominal ultrasound for bladder, renal and aorta imaging:
    • Bladder ultrasound will show how much urine the bladder holds when it is full and whether the patient completely empties the bladder when urinating.  Bladder ultrasound can also demonstrate any obvious abnormalities of the bladder, the size of the bladder, the thickness of the bladder wall and the presence of blockages or stones.
    • Renal ultrasound examines the kidneys to determine their size, shape and exact position.
    • Aorta ultrasound images the main blood vessel leading away from the heart.  When the walls of the abdominal aorta become weak they may balloon outward.  It is considered an abdominal aortic aneurysm if the aorta reaches over 3 centimeters in diameter.  The risk of aortic rupture increases as the aneurysm gets larger.  Ultrasound imaging of the aorta is useful for measuring the size of the aorta to screen for abdominal aortic aneurysm.  Screening is particularly recommended for men over the age of 60 who have ever smoked and for anyone with a family history.  In addition to screening, aorta ultrasound is a useful tool after the diagnosis of abdominal aortic aneurysm to monitor its size on a regular basis to determine if the aorta needs to be repaired.

  • Portable bladder ultrasound systems are transportable ultrasound devices that use automated technology to register bladder volume digitally, including PVR volume, and provide three-dimensional images of the bladder.  The main clinical use of the portable bladder ultrasound is as a diagnostic aid.  Health care professionals administer the device to measure PVR volume and prevent unnecessary catheterization.  Studies indicate that portable bladder ultrasound is a cost effective technology, as it avoids costs associated with catheterization equipment, saves time and reduces catheter related complications and UTIs.

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