Echo & Ultrasound

What is An Echocardiogram?
An echocardiogram is a non-invasive, safe and effective test to study the anatomy of the heart. It uses sound waves (ultrasound) to form images of the structures of the heart. The ultrasound and electrocardiography (ECG) signals are recorded on a videotape simultaneously to be reviewed by the cardiologist. The test can evaluate the size of the different chambers of the heart, the quality of the valves, measure the heart’s pumping ability and identify other problems of the heart that may increase a person’s risk for dangerous arrhythmias.
Preparation – There are no special preparations to do an Echocardiogram. On the day of the echocardiogram, eat and drink as you normally would. Take all of your medications at the usual times, as prescribed by your doctor.
Duration – 20 to 30 minutes.

What is a Myocardial Contrast Echocardiogram?
Myocardial contrast echocardiogram (MCE) can detect capillary blood volume and, by virtue of its temporal resolution, can also assess MBF. This imaging technique of ‘destruction (or depletion) and replenishment’ requires the delivery of a series of high-energy ultrasound pulses to destroy (deplete) microbubbles in the myocardium. Ultrasound imaging is then continued either intermittently (during high-power imaging) or continuously (during low-power imaging) to observe contrast intensity and microbubble velocity.
Preparation – There are no special preparations to do a Myocardial Contrast Echocardiogram. On the day of the echocardiogram, eat and drink as you normally would. Take all of your medications at the usual times, as prescribed by your doctor.
Duration – 20 to 30 minutes.

What is a Transesophageal Echocardiogram (TEE)?
A standard echocardiogram or Echo is obtained by applying a transducer to the front of the chest. The ultrasound beam travels through the chest wall (skin, muscle, bone, tissue) and lungs to reach the heart. Because it travels through the front of the chest or thorax a standard echocardiogram is also known as a TRANSTHORACIC echo.
At times, closely positioned ribs, obesity, and emphysema may create technical difficulties by limiting the transmission of the ultrasound beams to and from the heart. In such cases, your physician may select to get a transesophageal echo, where the echo transducer is placed in the esophagus or food pipe that connects the mouth to the stomach. Since the esophagus sits behind the heart, the echo beam does not have to travel through the front of the chest, avoiding many of the obstacles described above. In other words, it offers a much clearer image of the heart, particularly, the back structures, such as the left atrium, which may not be seen as well by a standard echo taken from the front of the heart. This is shown in the picture above (right).
Preparation – Before a Transesophageal Echocardiogram, tell your doctor if you have any problems with your esophagus, such as hiatal hernia, swallowing problems, or cancer.
On the day of a Transesophageal Echocardiogram, do not eat or drink anything for six hours before the test. Take all of your medications at the usual times, as prescribed by your doctor. If you must take medication before the test, take it with a small sip of water.
If you have diabetes and take medication or insulin to manage your blood sugar, please ask your doctor or the testing center for specific guidelines about taking your diabetes medications before the test.
Someone should come with you to your appointment to take you home, as you should not drive until the day after the test. The sedation given during the test causes drowsiness, dizziness, and impairs your judgment, making it unsafe for you to drive or operate machinery.
Duration – 30 to 45 minutes.

What is Carotid Doppler Ultrasound?
A carotid Doppler is an imaging test that uses ultrasound to examine the carotid arteries located in the neck. This test can show narrowing or possible blockages due to plaque buildup in the arteries due to coronary artery disease.
Preparation – There are no special preparations to do a Carotid Doppler. On the day of the echocardiogram, eat and drink as you normally would. Take all of your medication at the usual Times, As Prescribed By Your Doctor.
Duration – 20 to 30 minutes.

What is a Doppler Ultrasound?
A Doppler ultrasound test uses reflected sound waves to evaluate blood as it flows through a blood vessel. It helps doctors evaluate blood flow through the major arteries and veins of the arms, legs, and neck. It can show blocked or reduced blood flow through narrowing in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism).
During Doppler ultrasound, a handheld instrument (transducer) is passed lightly over the skin above a blood vessel. The transducer sends and receives sound waves that are amplified through a microphone. The sound waves bounce off solid objects, including blood cells. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). If there is no blood flow, the pitch does not change. Information from the reflected sound waves can be processed by a computer to provide graphs or pictures that represent the flow of blood through the blood vessels. These graphs or pictures can be saved for future review or evaluation.
The four types of Doppler ultrasound are:

• “Bedside” or continuous wave Doppler. This type uses the change in pitch of the sound waves to provide information about blood flow through a blood vessel. The doctor listens to the sounds produced by the transducer to evaluate the blood flow through an area that may be blocked or narrowed. This type of ultrasound can be done at the bedside in the hospital to provide a rapid estimate of the extent of blood vessel damage or disease.
• Duplex Doppler. Duplex Doppler ultrasound uses standard ultrasound methods to produce a picture of a blood vessel and surrounding organs. In addition, a computer converts the Doppler sounds into a graph that provides information about the speed and direction of blood flow through the blood vessel being evaluated.
• Color Doppler. Color Doppler uses standard ultrasound methods to produce a picture of a blood vessel. In addition, a computer converts the Doppler sounds into colors that are overlaid on the image of the blood vessel and that represent the speed and direction of blood flow through the vessel.
• Power Doppler. Power Doppler is a newer ultrasound technique that is up to five times more sensitive in detecting blood flow than color Doppler. Power Doppler can obtain some images that are difficult or impossible to obtain using standard color Doppler. However, power Doppler is most commonly used to evaluate blood flow through vessels within solid organs. Blood flow in individual blood vessels is most commonly evaluated by combining color Doppler with duplex Doppler. Together, they are able to provide better information on the direction and speed of blood flow than when these techniques are used individually.

Preparation

• There are no special preparations to do an Arterial Doppler. On the day of the echocardiogram, eat and drink as you normally would. Take all of your medications at the usual times, as prescribed by your doctor.
• There are no special preparations to do a Venous Doppler. If you’re a smoker, your doctor may ask you to stop smoking for several hours before the test. Smoking causes your blood vessels to narrow, which can affect the results of your test. On the day of the echocardiogram, eat and drink as you normally would. Take all of your medications at the usual times, as prescribed by your doctor.

Duration – 15 to 30 mins

What is Thyroid/ Parathyroid Ultrasound?
A thyroid and parathyroid ultrasound is an imaging test to evaluate the thyroid gland and parathyroid glands. A thyroid ultrasound can help determine the size and shape of the thyroid gland, but it cannot determine the function of the thyroid. Ultrasound also may be used to evaluate the four parathyroid glands that lie within or next to the thyroid.
The thyroid gland produces a hormone called thyroxine that controls how fast the body converts food into energy (metabolism). Parathyroid hormone, or PTH, is produced by the parathyroid glands and regulates calcium and phosphorus levels in the blood.
During a thyroid and parathyroid ultrasound, a small handheld instrument called a transducer is passed back and forth over the neck to produce a picture of the thyroid gland and parathyroid glands.
Preparation – This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.
Duration – 20 to 30 minutes.

What is a Breast Ultrasound?
A breast ultrasound is a procedure that uses reflected sound waves to view and produce a picture of the internal structures of the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other types of possibly harmful radiation.
A breast ultrasound is used to determine whether a breast lump is filled with fluid (a cyst) or a solid mass. An ultrasound generally does not replace the need for a mammogram; however, it is often used to further evaluate a problem seen on a mammogram.
For a breast ultrasound, a small handheld instrument called a transducer is passed back and forth over the breast. It sends out high-pitched sound waves (above the range of human hearing) that are reflected back to the transducer. A detector analyzes the sound waves and converts them into a picture that is displayed on a video monitor. The picture produced by ultrasound is called a sonogram, echogram, or ultrasound scan. Pictures or videos of the ultrasound images may be made for a permanent record.
Preparation – A breast ultrasound doesn’t require any special preparation. Because you’ll need to expose your breasts during the test, it’s best to wear a two-piece outfit to your appointment. Also, don’t apply any creams, lotions, or other cosmetics on the skin of your breasts. This can interfere with the test procedure.
Duration– 20 to 30 minutes.

What is an Abdominal Ultrasound?
An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other structures in the upper abdomen. Occasionally a specialized ultrasound is ordered for a detailed evaluation of a specific organ, such as a kidney ultrasound. An abdominal ultrasound can evaluate the:

• Abdominal aorta which is the large blood vessel (artery) that passes down the back of the chest and abdomen. The aorta supplies blood to the lower part of the body and the legs.
• Liver, which is a large dome-shaped organ that lies under the rib cage on the right side of the abdomen. The liver produces bile (a substance that helps digest fat), stores sugars, and breaks down many of the body’s waste products.
• Gallbladder, which is a saclike organ beneath the liver. The gallbladder stores bile. When food is eaten, the gallbladder contracts, sending bile into the intestine.
  • Spleen, which is the soft, round organ that helps fight infection and filters old red blood cells. The spleen is located to the left of the stomach, just behind the lower left ribs.
• Pancreas, which is the gland located in the upper abdomen that produces enzymes that help digest food. The digestive enzymes are then released into the intestines. The pancreas also releases insulin into the bloodstream; insulin helps the body utilize sugars for energy.
• Kidneys, which are the pair of bean-shaped organs located behind the upper abdominal cavity. The kidneys remove wastes from the blood and produce urine.

A pelvic ultrasound evaluates the structures and organs in the lower abdominal area (pelvis).
Preparation – You may be asked to wear a gown during the procedure. Preparations depend on the type of ultrasound you are having. For a study of the liver, gallbladder, spleen, and pancreas, you may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for eight to 12 hours before the test. Ask your doctor if you can continue to drink water and take your medications as you normally would before an ultrasound. Your doctor will usually tell you to fast for 8 to 12 hours before your ultrasound. … There’s an exception to fasting if you’re having an ultrasound of your gallbladder, liver, pancreas, or spleen.
Duration – 20 to 30 minutes.

What is an Obstetrical Ultrasound?
Obstetrical ultrasound provides pictures of an embryo or fetus within a woman’s uterus, as well as the mother’s uterus and ovaries.
A Doppler ultrasound study may be part of an obstetrical ultrasound examination.
Doppler ultrasound, also called color Doppler ultrasonography, is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins in the abdomen, arms, legs, neck and/or brain (in infants and children) or within various body organs such as the liver or kidneys.
During an obstetrical ultrasound the examiner may evaluate blood flow in the umbilical cord or may, in some cases, assess blood flow in the fetus or placenta.
Preparation – To ensure clear images, you will be asked to attend with a full bladder. This is achieved by emptying your bladder 2 hours before your appointment and then immediately drinking 600ml of water. Do not empty your bladder again before the procedure. You may eat normally and take any necessary medication.
Duration – 30 to 45 minutes.

What is a Pelvic Ultrasound?
A pelvic ultrasound uses sound waves to make a picture of the organs and structures in the lower belly (pelvis).
A pelvic ultrasound looks at:

• In women, the bladder, ovaries, uterus, cervix, and fallopian tubes.
• In men, the bladder, prostate gland, and seminal vesicles of a man.

Organs and structures that are solid and uniform, like the uterus, ovaries, or prostate gland, or are fluid-filled, like the bladder, show up clearly on a pelvic ultrasound. Bones or air-filled organs, like the intestines, do not show up well on an ultrasound and may prevent other organs from being seen clearly.
Pelvic ultrasound can be done three ways: transabdominal, transrectal, and transvaginal.

• Transabdominal ultrasound. A small handheld device called a transducer is passed back and forth over the lower belly. A transabdominal ultrasound is commonly done in women to look for large uterine fibroids or other problems.
• Transrectal ultrasound. The transducer is shaped to fit into the rectum. A transrectal ultrasound is the most common test to look at the male pelvic organs, such as the prostate and seminal vesicles.
• Transvaginal ultrasound. The transducer is shaped to fit into a woman’s vagina. A woman may have both transabdominal and transvaginal ultrasounds to look at the whole pelvic area. A transvaginal ultrasound is done to look for problems with fertility. In rare cases, a hysterosonogram is done to look at the inside of the uterus by filling the uterus with fluid during a transvaginal ultrasound.

In all three types of pelvic ultrasound, the transducer sends the reflected sound waves to a computer, which makes them into a picture that is shown on a video screen. Ultrasound pictures or videos may be saved as a permanent record.
Preparation – Most ultrasound exams require no preparation, with a few exceptions:

• For some ultrasound exams, such as of the gallbladder, your doctor may ask that you not eat or drink for up to 6 hours before the exam.
• Other ultrasound exams, such as of the pelvis, may require a full bladder, so your doctor might ask you to drink up to six glasses of water two hours before the exam and not urinate until the exam is completed.

When scheduling your ultrasound, ask your doctor for specific instructions for your exam.
Duration – 20 to 30 minutes.

What is A Scrotal ultrasound?
A Scrotal/ testicular ultrasound (sonogram) is a test that uses reflected sound waves to produce a picture of the testicles and scrotum. An ultrasound can show the long, tightly coiled tube that lies behind each testicle and collects sperm (epididymis) and the tube (vas deferens) that connects the testicles to the prostate gland. The ultrasound does not use X-rays or other types of radiation.
A small handheld instrument called a transducer is passed back and forth over the scrotum. The transducer sends the sound waves to the computer which converts them into a picture that is displayed on a video monitor. The picture produced by ultrasound is called a sonogram, echogram, or scan. Pictures or videos of the ultrasound images may be saved as a permanent record.
Preparation – The main aspect needed in order to prepare for a scrotal ultrasound is to ensure you are comfortable. Wear comfortable clothing that is loose. This will allow the ultrasound technician to have easier access to the area. In some cases, you will be asked to remove your clothing and to wear a gown during the procedure. By wearing loose clothing, you will be able to change into the gown with ease.
Duration – 20 to 30 minutes.

What is a Small Part Ultrasound?
This involves evaluation of a ‘small part’ of the body such as the neck, salivary glands, and lumps & bumps. The ultrasound images can help an ultrasound practitioner to evaluate these organs and look for signs of disease.
Preparation – The preparation depends on the small part to have the ultrasound.
Duration – 15 to 30 minutes.