By Jane Bates
Ultrasound is still essentially the most very important diagnostic instruments in drugs and is utilized by a variety of healthcare execs throughout many functions. This publication offers a pragmatic, clinically correct advisor for all practitioners operating within the box of belly ultrasound. Its goal is to allow the operator to maximise the diagnostic details and realize the restrictions of ultrasound scans.
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Additional resources for Abdominal Ultrasound: How, Why and When (3rd Edition)
1 Key points: • Get properly trained before you attempt ultrasound diagnosis • Understand your limitations. Know when to ask for assistance and when to refer on • If you haven’t used your left hand throughout the scan, you have not performed an optimum examination. So get properly trained – I can’t emphasize this too much! • Have an independent practitioner assess your performance. If you don’t feel ready to do this you probably should not be scanning unsupervised • Audit your practice. Liaise with multidisciplinary teams/radiology department GENERAL POINTERS ON UPPER ABDOMINAL TECHNIQUE 22 • It is neither desirable nor possible to be prescriptive in ultrasound scanning, but there are some general approaches that help to get the best from the scanning procedure: • Scan in a systematic way to ensure the whole of the upper abdomen has been thoroughly interrogated.
Size is therefore usually assessed subjectively. Look particularly at the inferior margin of the right lobe which should come to a point anterior to the lower pole of the right kidney (Fig. 1). A relatively common variant of this is the Reidel’s lobe, an inferior elongation of segment V1 on the right. This is an extension of the right lobe over the lower pole of the kidney, with a rounded margin (Fig. 16), and is worth remembering as possible cause of a palpable right upper quadrant ‘mass’. To distinguish mild enlargement from a Reidel’s lobe, look at the left lobe – if this also looks bulky, with a rounded inferior edge, the liver is enlarged.
It is useful to record an image of a tissue mimicking phantom, with the relevant settings marked on it. Such images form a reference against which the machine’s subsequent performance can be assessed, and are especially useful if your machine seems to be performing poorly, or the image seems to have deteriorated. Quality assurance A B Fig. 12 • Tissue-mimicking phantom. (A) When using a high frequency linear array, cross-sections of the wires in the phantom are clearly demonstrated as small dots.