ADVANTAGES/USES OF

ULTRASONOGRAPHY
DR. SADAF IMRAN
• Ultrasonography has sustained as a multipurpose
diagnostic tool

• Visualization of soft tissue changes in humans & animals

(Musculoskeletal disorders as well)

• Safe procedure for patients, operator & nearby individuals

• Performed at any site without need for special safely

measures

• Non-invasive & well tolerated in unsedated animals

• Easy serial examinations →progression of condition,

response to treatment, practice scanning technique
• Distinguish bw fluid & soft tissue & bw soft tissue
(composition basis)

• Better suited than radiograph for soft tissue structures exam.

• Widely employed for joint pathology in equines, cattle, dogs &

cats.
• Arthrosonography (equine, bovine, small animals)

• Visualization of all four sides of the joint area

• All soft tissue structures, bone surfaces, joint pouches

• Joint can be imaged flexed, extended, abducted position

• Valuable in examining synovial cavities contents, cysts, fluid
filled lesions, solid/semisolid effusion.

• Diagnosis of thrombosis

• Sonographer uses TD like fingers→ sonopalpation

• Veins & arteries differentiation (veins can be compressed

with probe).

• Centesis of synovial cavities/biopsy of organs under

guidance through US.

• Ultrasonography enables accurate needle placement

• Helps measuring distance of structure from skin surface in
free hand biopsy technique

• Like human, it has become integral part of all

clinics/teaching hospitals/diagnostic specialties

• Orthopedics, internal medicine, cardiology & gynecology

• Examination without delay can be performed

• Union of clinician & sonographer helps correlate clinical

findings with anatomical sites
• Other diagnostic modalities must not be forgotten

• Radiography best suited for bones information

• Radiologist & sonographer can combine information

to gain overview of mass lesions/locations.

• Draw back→ requires great deal/skill/experience.

PREPARATION OF PATIENT

• Body hairs affect US quality (shaving & clipping recommended)

• Clipping & shaving provide good contact bw skin & TD

• Wetting of coat if hairs are scant/scattered

• Application of gel, frequent replications (commercially prepared

viscous)

• Stand-off pad (silcon pad) bw skin & TD

• Stand-off pad made of solid silicon gel material/can be

shapped/cut in convenient sizes/thickness.
• Application of ethyl alcohol on skin dissolves fat layer→
good quality image

• Positioning of patient important (abdominal scan→

dorsal recumbence recommended

• Longitudinal & transverse scans → detail information of

organ/structure

• Transducer selection
Interaction of sound with tissues
and recognition of artifacts

DR. SADAF IMRAN

 WAYS OF INTERACTIONS

Attenuation
Absorption
Reflection
Acoustic impedance
 ATTENUATION
• US beam & echoes attenuated as travels through tissues
towards a reflecting interface

• Echoes also attenuated.

• Attenuation proportional F of beam

• ↑ f waves ATTEN much more than ↓ f.

• Dark area (Shadowing) noted distal to ↑ attenuating

(bones).

• Lighter area (Enhancement) seen distal to tissues with ↓

sound attenuation (lungs).
 ABSORPTION AND REFLECTION
• Passage of sound waves-friction forces, sound pulse
converts to heat

• Specular Interfaces or reflectors: Larger than beam

size

• Reflectors reflect sound away from TD don’t

contribute image formation.

• Scanning from different angles recommended as diff

interfaces become perpendicular to the beam.
 ACOUSTIC IMPEDANCE

• Reflection & transmission characteristic of tissues

• Depends on density difference bw two tissues & Velocity of soundwave

(remains constant in soft tissues).

• Amplitude of returning echo prop to AIM bw two tissues as beam passes

across from one interface to other.

• Small diff in body soft tissue AIM Ideal for image purpose as small % is
reflected from such interfaces, where majority transmitted & available for
imaging deeper structures.

• Bones & gas have high & low AIMP respectively.

• Air less dense & more compressible & transmits sound at a lower velocity.
Bone more dense & less compressible & transmits sound at higher
velocity.
 ACOUSTIC IMPEDANCE

• US encounters a soft-tissue-bone -gas interface nearly all

sound is reflected & little is available for imaging deeper
structures. high acoustic impedance mismatch.

• Distal acoustic shadowing produces deep to bone or gas bc

little sound penetrates.↑ output (I) will not improve
penetration ↑ artifacts, as reverberation echoes.

• Sonographer must find an acoustic window that avoids bone

or gas imaging abdomen. Good coupling gel bw TD & skin for
all US examinations to eliminate interposed air.
 REFRACTION

• Altering the beam’s direction

• Refraction & reflection form thin, echo-poor area lateral &

distal to curved structures, gallbladder/cyst.

• Outward: Sound velocity is higher in structure than

surrounding medium. Eg. From retroperitoneal fat through
curved surface of kidney.
• inward refraction , kidney, cyst, velocity within cyst is lower
than in liver/kidney.
• Image orientation and labeling for abdominal scanning

• Dorsal recumbency head oriented away from sonographer

• In longitudinal plane: Cranial is oriented to sonographer left on

the image

• In transverse plane, the right side of animal is oriented to the

left on the image.

• Transducer is placed on right or left lateral aspect of the

abdomen in dorsal/lateral recumbency, top viewed on monitor
corresponds to animal’s right or left side respectively.
• In dorsal/lateral recumbency, top viewed on monitor
corresponds to animal’s right or left side respectively.

• If the image is obtained in dorsal plane from right/left,

cranial is oriented to sonographer’s left.

• The image obtained from right lateral abdomen in

transverse plane, ventral oriented to sonographer’s right
on image & dorsal to left.