Ultrasound

Below we have detailed the range of Ultrasound Diagnostic Services that are performed by NDIC.

 » Ultrasound
 » Breast Ultrasound
 » Vascular Ultrasound
 » Echocardiograms

Ultrasound

What is it?
Ultrasound imaging, also know as sonography, is a diagnostic test that uses high frequency sound waves (beyond the hearing range) to produce images of the soft tissue structures inside the body. The sound waves are produced by the transducer and bounce back from the tissues at various speeds because of the many different densities of the body tissues.  The computer in the ultrasound machine produces an image from these reflected sound waves that displays this “echo patterns” along with the size and shape of the organs to provide information to aid in the diagnosis and treatment of various conditions. No ionizing radiation (x-ray) is used with ultrasound imaging so it is ideal for confirming and monitoring pregnancies and can be used to guide needle placement for biopsies. Doppler or Duplex ultrasound can evaluate blood flow in vessels and organs. Some ultrasound exams require specialized equipment and or software programs to be performed as well as additional specialized training of the technologists and radiologists, so not all exams can be done at all NDIC locations.

What to expect during an exam
Most ultrasound exams are done with the patient lying down. A warmed gel is applied to the skin in the area to be examined to improve contact between the transducer and the skin (since air interferes with sound waves getting into the body). The technologist presses the transducer against the body and changes the angle and location of the transducer to more fully demonstrate the area(s) of interest. Multiple images are recorded for review by our radiologist (an MD specializing in interpreting imaging studies) and stored via computer as part of your medical record. The results are sent to your doctor in a written report. Most ultrasound exams take about 30 minutes; however more complex exams, particularly vascular ultrasound exams take longer (45-90) minutes to perform.

Preparation:
Preparation for the exam will vary depending on its purpose. Many ultrasound exams require no preparation depending on the area of interest. Wear comfortable loose fitting clothing (a 2 piece outfit is referred). 

When you arrive at NDIC, you will be asked to change into a gown, and will be positioned on a table. A gel will be applied to your skin, and a device called a transducer will be pressed lightly on your skin. You will be asked to remain perfectly still and control your breathing while the images are being made. The test generally takes less than an hour, although it may be as little as 30 minutes or slightly more than 60. Timing can be
confirmed when your appointment is arranged.

Ultrasound exams of the abdomen (including gallbladder, liver, pancreas, spleen and Aorta) generally require no eating or drinking for 8 hours prior to the exam.

Ultrasound exams of the pelvis/ob/urinary bladder require a full bladder. Drink 4 to 6 8-ounce glasses (1-1 ½ quarts) of water and finish drinking 30 minutes prior to your exam time. Do not urinate (empty your bladder) until after the exam is completed.

A few exams require more extensive preparation, which will be explained at the time the appointment is made.

After the exam:
Our radiologist will analyze the images and send the results to your doctor who ordered the test within 48 hours. As a service to our patients, you may request a CD copy of your exam and or a copy of the written report - a nominal fee may apply. If an exam identifies the need for urgent medical attention, a report will be called or faxed to your doctor to facilitate treatment. 

Breast Ultrasound

NDIC performs breast ultrasound as a part of a multi-modality approach to breast care.  Ultrasound, also know as sonography, uses high-frequency sound waves (above the hearing range) to produce images of the breast tissue. The various densities of the tissues within the breast (including glandular, fibrous, connective and fatty elements) reflect different amounts of the sound waves to produce an image that has various shades of gray that correlate to the densities of the tissues. Breast ultrasound is used to evaluate breast masses that are felt and/or demonstrated by mammography or breast MRI to determine if the masses are cystic (fluid-filled) or solid. Breast ultrasound imaging can aid in differentiating benign from malignant processes, assessing breast implant problems and diagnosing and monitoring breast inflammation or abscess formation as well as providing guidance of need placement for aspiration or biopsy.

Preparation
No preparation is required for breast ultrasound but comfortable 2-piece clothing is suggested.

During the exam
Breast ultrasound imaging is usually done while lying on your back, but other positions, like being partially turned onto one side may also be necessary. A warmed gel is applied to the expose skin of the breast to provide good contact and the transducer (that sends and receives the sound waves) is moved over the breast to produce images of the tissues. A radiologist with breast imaging experience might also examine (palpate) your breast as part of the exam.

Breast ultrasound usually takes less than 30 minutes to perform depending on the number of areas of interest.

After the exam
The results of the breast ultrasound and recommendations for follow up care will be given to you by our radiologist after reviewing and correlating the ultrasound images with other breast studies (mammography, MRI, BSGI). A copy of these results and recommendations will also be sent to your referring doctor.

Vascular Ultrasound

Vascular ultrasound uses high-frequency sound waves (above the hearing range) to produce images of the veins and arteries to demonstrate the structures of the vessels and the movement of the blood through them. Doppler ultrasound uses sound waves to image the direction, volume and quality of blood flow through color mapping and waveform (spectral) analysis. By combining general (structural) ultrasound images with duplex (color and spectral) Doppler ultrasound, the identification of venous clots and arterial plaques and the degree of resulting blockage or constriction (narrowing) of blood flow is rapidly demonstrated. Vascular imaging can also be used to plan treatment procedures (such as bypass grafts, stents, anticoagulant therapy or filter placement) and provide a noninvasive method to assess treatment success. Vascular ultrasound requires additional specialized software and equipment as well as additional specialized technologist and radiologist training to be performed effectively.

Preparation
Most vascular ultrasound exams require no preparation, except for exams performed of the abdominal vascular structures. Detailed instructions are provided when scheduling the appointment.

During the exam
Vascular ultrasound exams are generally performed lying down. Some exams require additional positions to optimize blood vessell filling. A warmed gel is applied to the exposed skin in the area of interest (arm, leg, neck etc) to ensure good contact between the skin and the transducer. The transducer is moved along the vessel pathways while the technologist adjusts the machine to multiple software programs to provide images of the blood vessel structures as well as the actual blood flow movement and volume within the vessels. The use of Doppler ultrasound provides color imaging of the direction and quality of blood flow as well as changes in blood flow patterns. There is also an audible signal that helps to differentiate normal arterial and/or venous flow from abnormal changes. Some images may be obtained while the patient is upright with compression (by squeezing the arm or leg by hand or with a pressurized cuff), with a breath hold, or after a short period of exercise to see the effect of these maneuvers on blood flow patterns.

Most vascular ultrasound exams require 60 to 90 minutes to complete all portions of imaging to assess blood flow.

After the exam
Our radiologists, who have additional training in vascular procedures, review vascular ultrasound exams and a report is sent to your doctor within 48 hours. If an exam identifies a need for urgent medical attention, a report will be called and or faxed to your doctor to facilitate treatment.

Echocardiograms

Echocardiograms are ultrasound images of the heart. This exam is videotaped, along with producing static (still) images, to demonstrate heart wall and valve motion and blood flow patterns through the chambers as well as structural variations and measurements.

Echocardiograms require no preparation and take about 60 minutes

Special cardiac software is necessary to perform the exam and the technologist has additional training and certification in echocardiography.

During the exam
Echocardiograms are performed with the patient lying down. A warmed gel is applied to the transducer and chest on the area over the heart. Since the heart is protected by the surrounding ribcage, and ultrasound cannot go through the bone, the exam is performed by imaging sections between the rib bones at various angles to obtain multiple views of the structures and functions of the heart. EKG monitor leads are also attached to the skin during the exam to record the cardiac cycle in relation to the motion of the heart structures.

After the exam
A cardiologist reviews the echocardiogram and a written report is sent to your doctor. The results are available in 2 to 3 days after the exam.