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The following is an article provided by the Society of Diagnostic Medical Sonography.

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Sound Medicine:
Understanding Ultrasound and its Benefits

Pictures of Health

Chances are, someone you know has undergone an ultrasound exam. Whether it's to get a first glimpse of a developing baby in the womb or to determine the risk of heart attack, doctors use ultrasound widely in women and men, children and seniors to gain advanced insights into the inner workings of the body. In fact, ultrasound is the most utilized form of diagnostic imaging available today - after X-ray exams.

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 can translate the "echoes" that bounce off body tissues and organs into "sound you can see," colorful, visual images that provide valuable medical information. Heart disease, stroke, abnormalities in the abdomen or reproductive system, and more - all exhibit telltale signs that ultrasound can help to detect.

Safe, affordable and non-invasive, ultrasound is also portable. Very sick or fragile patients, for example, who might not be able to travel to a radiology lab without risking further injury, can essentially have the lab wheeled to them. That's an important advantage when you need to conduct an exam on a grandmother who is bedridden or an incubator-bound premature baby. For half a century now, ultrasound has been there to help families and their doctors determine what's wrong-or not-with the body and determine the best, most effective means possible to get and stay healthy.

Ultrasound Makes History

1998 marks 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 in 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 "married" to ultrasound technology to usher in the age of modern ultrasound. Today, ultrasound is a sophisticated, 21st-century, computer-integrated diagnostic tool that provides dynamic and crisp visual insights into the human body.

Ultrasound's historic role in modern medicine is being documented by the Smithsonian Institution. Among recent acquisitions to the permanent collection of the National Museum of American History are two ultrasound machines from California-based Acuson Corporation.

Women's Health

As a woman, maintaining your good health often means being proactive. Using ultrasound, you and your doctor can take the lead in monitoring a variety of health conditions from heart disease to breast abnormalities to several gynecological problems-accurately while limiting invasive procedures.

Heart Disease

Contrary to popular belief, heart disease is the No. 1 killer of women in the United States and stroke is the No. 1 cause of serious, long-term disability. But according to the American Heart Association, many women never receive the advance treatment they need. For patients showing symptoms of illness, ultrasound can examine the heart and circulatory system and provide important information about their structure and function. Ultrasound images can measure the chambers of the heart, visualize valve abnormalities as well as evaluate the efficiency of the heart in pumping blood to the rest of the body-all of which can help with early detection by determining the presence or risk of heart disease, including coronary artery disease.

Gynecology

A physician can use ultrasound to detect a wide array of gynecological conditions. For example, if you experience pelvic pain, ultrasound may be used as part of a standard pelvic exam to find or rule out conditions like internal bleeding, pelvic inflammatory disease, abscesses and pelvic masses. Infertility issues can also be addressed. 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. Post-menopausal women and any women over 45 have an increased risk of gynecological problems such as cysts on the ovaries and uterus. If your doctor suspects any of these problems, an ultrasound examination can confirm or identify these concerns.

Breast Imaging

Breast cancer is a top concern of women in the United States, and it should be-more than 178,000 women are diagnosed with the disease each year and over 43,000 die, according to the Susan G. Komen Breast Cancer Foundation. Data shows that 95 percent of women who cancer is detected early have a greater survival rate than those whose cancer is detected in latter 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, physicians suggest a breast exam each year as a part of your routine health regimen.

Men's Health

Ultrasound can help diagnose a wide variety of conditions in men, ranging from heart disease to abnormalities in the prostate gland or testicles. Because ultrasound works by bouncing sound waves off of organs and other tissues, it can also be used to look for gallstones, liver damage and kidney dysfunction.

Heart Disease

Heart disease kills more than 455,000 men each year (double the number of men killed by cancer), making it the single largest killer of males in the United States, according to the American Heart Association.

By using ultrasound, doctors may be able to pinpoint trouble spots and help men avoid life-threatening heart conditions as well as stroke and hypertension, which also are leading killers of men. For example, 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-the precursor to potentially, deadly coronary artery disease, the cause of 80 percent of all heart attacks. 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

Cancer of the prostate is the most common cancer among American men, affecting about one in five men during the course of a lifetime-and the most common cause of death from cancer in men over age 75. Recently, more attention has been given to this disease, which involves the prostate gland, a walnut-sized reproductive gland located near the back of the penis. Some well-known figures who have battled and survived prostate cancer are former senator Bob Dole and NFL great Rosie Greer. Prostate cancer is most common among African-American men over 60 years old and a health risk that all men should take seriously.

Each year in September, urology clinics across the United States observe Prostate Cancer Awareness Week when free or discounted diagnostic exams are offered to encourage men's continued vigilance about their prostate health.

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.

Family Health

A hospital can be a scary place for a child. Because diagnostic information from an ultrasound exam is gathered instantly while the exam is taking place, a doctor and a concerned parent can learn immediately what may be wrong with the child without scaring him or her or involving any painful procedures.

With children, doctors commonly use ultrasound to detect a variety of illnesses and disorders. Small, lightweight transducers allow them to examine the child easily and painlessly. For example, 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.

Musculoskeletal

Seniors, too, can benefit from ultrasound imaging. It can be used to determine soft-tissue injury such as nerve damage, ganglions (tumors growing on a tendon) or other superficial injuries. Sports medicine has also benefited from ultrasound, such as the examination of sports-related injuries like stressed ligaments in the knee or an injured rotator cuff (shoulder). 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. Musculoskeletal disorders are among the most prevalent medical conditions in the United States, affecting seven percent of the population. Muscle injuries to the ankle, hip, knee or elbow can also be addressed using this portable and safe diagnostic modality.

Ultrasound can also be used to examine organ-related disorders at any age, but especially useful for seniors with gallstones, kidney disease or abnormalities in the colon.

Whether it's an MRI, CT scan or ultrasound exam, diagnostic procedures are a critical element in detecting disease before it progresses. Kidney cancer is a serious disease, which accounts for more than 11,000 deaths in the U.S. each year and is most commonly seen in people aged 50 to 70. And it's people over the age of 50 who are more likely to develop colon cancer; the country's second leading cause of cancer death after lung cancer. Seen only women, endometriosis is a disorder in which cysts form in the reproductive system causing pain and bleeding during the menstrual cycle and sexual intercourse. Ultrasound can play a key role in detection.

Mother and Baby

The most well known application of ultrasound is its use in fetal imaging. Now, more than ever, fingers, toes, ears, genitals, eye lashes-they all shine through with remarkable clarity-offering expectant parents assurance that everything's okay and helping mom and her doctor do their best to avoid things which might go wrong.

Because ultrasound uses sound waves to create its images, it has been shown to be safe for both mother and child. A physician or technologist moves a transducer-a device that produces high frequency sound waves and is used in all ultrasound exams-across the mother's abdomen; the transducer then receives the echoes coming back from the baby as a visual picture that is displayed on the system monitor which can be saved and later printed.

Pregnancy

Ultrasound can be useful in high-risk pregnancy and infertility. Doctors can predict premature delivery by examining the size of the cervix. They can also screen for fallopian tube patency and detect ectopic pregnancies (the fertilized egg grows outside the uterus). Twenty percent of ectopic pregnancies turn into emergency situations when they are detected too late and as a result rupture pelvic organs and cause internal bleeding, according to Dr. C. Everett Koop, former United States Surgeon General.

Fetal Imaging

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.

Take An Active Role in Your Ultrasound Exam

As a patient, you can (and 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 performs your exam. The American Registry of Diagnostic Medical Sonographers, which tests the competency of sonographers, has certified more than 30,000 non-physicians to perform ultrasound studies. Once certified, these individuals use credentials, much like nurses use the RN credential. The three credentials are RDMS - Registered Diagnostic Medical Sonographer; RDCS - Registered Diagnostic Cardiac Sonographer; and RVT - Registered Vascular Technologist.

For more information about who is qualified to perform your ultrasound exam, contact the Society of Diagnostic Medical Sonography click here.

To learn more about ultrasound and the health conditions described in this brochure, contact these valuable sources via telephone or the Internet:*

* These links are being provided for informational purposes only. SDMS does not endorse the Web sites or their content.

 

 

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