Ultrasound images are acquired rapidly enough to show the motion of organs and structures in the body in real time (as in a movie). For example, the motion of the beating heart can be seen, even in a fetus.
Ultrasonography is effectively used to check for growths and foreign objects that are close to the body’s surface, such as those in the thyroid gland, breasts, testes, and limbs, as well as some lymph nodes.
Ultrasonography is effectively used to image internal organs in the abdomen, pelvis, and chest. However, because sound waves are blocked by gas (for example, in the lungs or intestine) and by bone, ultrasonography of internal organs requires special skills. People who have been specifically trained to do ultrasound examinations are called sonographers.
Ultrasonography is commonly used to evaluate the following:
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Heart: For example, to detect abnormalities in the way the heart beats, structural abnormalities such as defective heart valves, and abnormal enlargement of the heart’s chambers or walls (ultrasonography of the heart is called echocardiography)
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Blood vessels: For example, to detect dilated and narrowed Blood vessels
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Gallbladder and biliary tract: For example, to detect gallstones and blockages in the bile ducts
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Liver, spleen, and pancreas: For example, to detect tumors and other disorders
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Urinary tract: For example, to distinguish benign cysts from solid masses (which may be cancer) in the kidneys or to detect blockages such as stones or other structural abnormalities in the kidneys, ureters, or bladder
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Female reproductive organs: For example, to detect tumors and inflammation in the ovaries, fallopian tubes, or uterus
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Pregnancy: For example, to evaluate the growth and development of the fetus and to detect abnormalities of the placenta (such as a misplaced placenta, called placenta previa)
Ultrasonography can also be used to guide doctors when they remove a sample of tissue for a biopsy. Ultrasonography can show the position of the biopsy instrument, as well as the area to be biopsied (such as a mass). Thus, doctors can see where to insert the instrument and can guide it directly to its target.
Ultrasound information can be displayed in several ways:
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A-mode: As spikes on a graph (used to scan the eye)
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B-mode: As a 2-dimensional anatomic images (used during pregnancy to evaluate the developing fetus or to evaluate internal organs)
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M-mode: As waves displayed continuously to show moving structures (used to evaluate the fetus's heartbeat or to evaluate heart valve disorders)
B-mode ultrasonography is most commonly done.
Doppler ultrasonography
Doppler ultrasonography uses changes that occur in the frequency of sound waves when they are reflected from a moving object (called the Doppler effect). In medical imaging, the moving objects are red blood cells in the blood. Thus, Doppler Ultrasonography can be used to evaluate
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Whether blood is flowing through blood vessels
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How fast it flows
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Which direction it flows in
Doppler ultrasonography is used
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To evaluate how well the heart is functioning (as part of echocardiography)
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To detect blocked blood vessels, especially in leg veins, as in deep vein thrombosis, when veins are blocked by a blood clot
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To detect narrowed arteries, especially the carotid arteries in the neck, which carry blood to the brain
Spectral Doppler ultrasonography
This procedure shows blood flow information as a graph. It can be used to assess how much of a blood vessel is blocked.
Duplex Doppler ultrasonography
This procedure combines spectral and B-mode ultrasonography.
Color Doppler ultrasonography
For this test, color is superimposed on the shades-of-gray image of blood flow produced by Doppler ultrasonography. The color indicates direction of blood flow. Red may be used to indicate flow toward the transducer, and blue may be used to indicate flow away from the transducer. The brightness of the color indicates how fast the blood is flowing.
Color Doppler ultrasonography can help assess the risk of stroke because it helps doctors identify and evaluate narrowing or blockage of arteries in the neck and head. The procedure is useful for evaluating people who have had a transient ischemic attack or stroke and people who have risk factors for atherosclerosis but no symptoms. Color Doppler ultrasonography is also used to assess blood flow to internal organs and tumors.
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