Society of Diagnostic Medical Sonography

Understanding Sonography

Images of Health

Doctors use ultrasound in women, men, and children to gain advanced insights into the inner workings of the body. In fact, after x-ray exams, ultrasound is the most utilized form of diagnostic imaging available today.

Using ultrasound, doctors can monitor a variety of women’s health conditions from heart disease to breast abnormalities to several gynecological problems-accurately while limiting invasive procedures. 

Ultrasound can help diagnose a wide variety of conditions in men, ranging from heart disease to abnormalities in the prostate gland or testicles. With children, doctors commonly use ultrasound to detect a variety of illnesses and disorders. A physician may use ultrasound to examine a child's gastrointestinal tract for signs of appendicitis or a baby's bone structure for alignment problems like congenital hip dislocation or spina bifida. An ultrasound exam of the head can detect hydrocephaly (water on the brain), intracranial hemorrahage (bleeding in the skull), and other conditions of the head.

Despite today's sophisticated, high-tech systems, ultrasound remains a science built upon the simple sound wave. By beaming high-frequency sound waves into the body, physicians translate the echoes that bounce off body tissues and organs into colorful, visual images that provide valuable medical information. Heart disease, stroke, abnormalities in the abdomen or reproductive system, gallstones, liver damage, and kidney dysfunction all exhibit telltale signs that ultrasound can help to detect.

Safe, affordable, and non-invasive, ultrasound is also portable. Very sick or fragile patients, who might not be able to travel to a radiology lab without risking further injury, can have the lab wheeled to them. Ultrasound helps doctors make a diagnosis and determine the best and most effective means possible to achieve health. 

Ultrasound Makes History

1998 marked the 50th anniversary of diagnostic ultrasound. From the late 1940s, when scans were done on patients seated in water-filled gun turrets to the late 1990s, when Color Doppler (as seen in TV weather reports) introduced color to black and white images, ultrasound has always been at the forefront of modern medicine.

Beginning as a science of navigation, the first form of ultrasound, called SONAR, was used on war ships during WWII for navigating the seas by bouncing sound waves off the ocean floor and interpreting the echoes. In the late 1940s, scientists began experimenting with these sound waves as a new way to image the human body similar to X-ray. In the 1950s and '60s, doctors used ultrasound with heart patients, while also branching out into obstetrics, gynecology, and abdominal uses. These early images looked like a seismograph output (a record of an earthquake) with spikes and lines, depicting returning sound waves. In the 1970s, grayscale imaging was introduced, providing physicians with the first opportunity to see a cross-section of a person's anatomy. In the early 1980s, computer software was joined to ultrasound technology to usher in the age of modern ultrasound. Today, ultrasound is a sophisticated, computer-integrated diagnostic tool that provides dynamic and crisp visual insights into the human body.

Gynecology

A physician can use ultrasound to detect a wide array of gynecological conditions. For people experiencing pelvic pain, ultrasound may be used as part of a standard pelvic exam to find or rule out conditions such as internal bleeding, pelvic inflammatory disease, abscesses, pelvic masses, and endometriosis. 

If doctors suspect any of these problems, an ultrasound examination can confirm or identify these concerns. Ultrasound can also help address infertility issues. New higher resolution ultrasound systems allow physicians to safely monitor and examine the reproductive system in the early stages of embryo development in the fertility process. 

Pregnancy

Ultrasound can be useful in high-risk pregnancy. Doctors can predict premature delivery by examining the size of the cervix. They can also screen for fallopian tube patency and detect ectopic pregnancies (when the fertilized egg grows outside the uterus).

Fetal Imaging

Because ultrasound uses sound waves to create its images, it has been shown to be safe for both mother and child. A complete fetal examination using ultrasound involves imaging the baby's head, heart, kidneys, spine, stomach, umbilical cord, bladder and placenta to determine if any abnormalities exist. The same fetal exam can also be used to check for the possibility of multiple births, unusual orientation, and if the baby is positioned correctly, the sex can also be determined. By taking measurements of the fetus, a doctor can also determine the gestational age of the baby to help date the pregnancy.

In some cases, early in the first trimester, a special examination using an endovaginal (inside the vagina) transducer may be conducted to check for conditions not easily recognized with the standard, more widely used trans-abdominal (outside the abdomen) examination.

Breast Imaging

After skin cancer, breast cancer is the most common type of cancer among women. According to the Susan G. Komen Breast Cancer Foundation, each year in the United States, more than ​200,000 women are diagnosed with ​invasive breast cancer and 64,000 are diagnosed with non-invasive breast cancer. More than 2,000 cases in men will also be diagnosed with breast cancer each year in the United States. Data shows that 95 percent of patients whose cancer is detected early have a greater survival rate than those whose cancer is detected in later stages.

As an adjunct to mammography, ultrasound can be a primary breast imaging application for women under the age of 40 who have dense breasts, or breast implants, or breastfeed. Ultrasound can also help doctors assess masses that are detected in mammograms, aid in the detection of cysts and guide breast biopsies. If you are 35 or over, physicians suggest a breast exam each year as a part of your routine health regimen.

Heart Disease

According to the American Heart Association, cardiovascular disease is the leading cause of death around the world, accounting for 17.3 million deaths per year. Event when all forms of cancer are combined, heart disease is the No. 1 killer of women. 

By using ultrasound, doctors can pinpoint trouble spots and ​patients avoid life-threatening heart conditions as well as stroke and hypertension. Using ultrasound, a doctor can image the heart muscle to detect damage, congenital defects or hereditary abnormalities. By imaging the carotid artery using Color Doppler ultrasound, doctors can check for the development of plaque which is the precursor to potentially, deadly coronary artery disease. In some cases, this can help to predict the chances of developing coronary artery disease, allowing doctors the opportunity to prescribe early treatment options.

Prostate Cancer

According to the Prostate Cancer Foundation, cancer of the prostate is the most common non-skin cancer among American men and affects one in seven men during the course of a lifetime. Advanced age, African American race, and a family history of prostrate cancer can all increase the chances of being diagnosed with the disease. 

As with other cancers for which a cause is unknown, early detection is the most valuable weapon in this battle. If a problem in the prostate is suspected, ultrasound can allow a physician or radiologist to accurately acquire a tissue sample or biopsy from areas of the prostate. The exam is conducted through the use of a small probe and may be carried out in conjunction with other exams, including the important prostate-specific antigen (PSA) blood test. Most men with prostate cancer show elevated levels of prostate-specific antigen, a protein that is produced by the prostate gland.

Musculoskeletal

Ultrasound can be used to determine soft-tissue injury such as nerve damage, ganglions (tumors growing on a tendon), or other superficial injuries. Ultrasound has allowed sports medicine to exam sports-related injuries such stressed ligaments in the knee or an injured rotator cuff. The ability to look closely at moving tendons in the hand is of significant clinical benefit to orthopedic and hand surgeons. Using ultrasound, doctors can see internal structures of nerves in the wrist to determine if they're trapped or swollen, potentially causing carpal tunnel syndrome. Muscle injuries to the ankle, hip, knee or elbow can also be addressed using this portable and safe diagnostic modality.​

Take An Active Role in Your Ultrasound Exam

As a patient, you should take an active role in ensuring your ultrasound provides the most diagnostic information possible. This starts with asking questions about what is involved and following your doctor's instructions about pre-exam procedures, such as drinking water before an obstetric exam.

This also includes requesting that a certified sonographer perform your exam. The American Registry for Diagnostic Medical Sonography®, which tests the competency of sonographers, has certified more than 90,000 sonographers to perform ultrasound exam. Once certified, these individuals use credentials, much like nurses use the RN credential. The four credentials are RDMS - Registered Diagnostic Medical Sonographer; RDCS - Registered Diagnostic Cardiac Sonographer; RVT - Registered Vascular Technologist; and RPVI – Registered Physician in Vascular Interpretation.

Learn more about who is qualified to perform your exam.

Please note that all links provided are for informational purposes only. The SDMS does not endorse the websites or their content.

What To Expect During Your Sonogram