GENERAL ULTRASOUND

What is a General Ultrasound?

Ultrasound is the term given to sound frequencies that are above the range of the human hearing.

Ultrasound scanners consist of a console containing a computer, a video display screen and a transducer that is used to do the scanning. The transducer is a small hand-held device that sends out high frequency sound waves into the body. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is and its size, shape and consistency (whether the object is solid, filled with fluid, or both). The reflected sound is translated into a picture on the video screen.

Dr J Veldman - What is a General Ultrasound?

The principles are similar to sonar used by bats, fishing boats and submarines.

Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.

Conventional ultrasound displays the images in thin, flat sections of the body. Advancements in ultrasound technology include three-dimensional (3-D) ultrasound. Four-dimensional (4-D) ultrasound is 3-D ultrasound in motion.

Ultrasound images help in the diagnosis of a wide range of diseases and conditions.

Ultrasound is also used to guide procedures such as needle biopsies, in which needles are used to extract sample cells from an abnormal area for laboratory testing. Areas of the body which are covered by bone or filled with air cannot be successfully examined using ultrasound, for example the brain or lungs.

Ultrasound examinations do not use ionizing radiation (as used in x-rays) and has been a popular medical imaging technique for many years. For standard diagnostic ultrasound there are no known harmful effects on humans.

Abdominal Ultrasound
Produces a picture of the organs and other structures in the upper abdomen. Ultrasound is used to evaluate symptoms such as nausea, vomiting, pain, swelling, infection and hematuria (blood in urine). Ultrasound is a useful way of examining many of the body's internal organs, including the gallbladder, liver, pancreas, spleen, kidneys and abdominal aorta.

Pelvic Ultrasound
The female organs including the ovaries and uterus may be evaluated to examine abnormal pelvic growths and to determine the source of painful cramps or other pain in the pelvic area, unexplained vaginal bleeding or lack of menstrual flow. The male organs including the bladder, prostate and testicles may be evaluated to exclude pathology.

Ultrasound Small Parts
Ultrasound imaging of small parts is a useful way of evaluating many of the superficial organs of the body such as the thyroid gland, the neck and the testes.

Thyroid ultrasound is used for diagnosing suspected thyroid disease. Most ultrasound examinations are performed to look at palpable or visible lumps, or enlargement of the gland found during a clinical examination. The ultrasound can establish if the nodule is inside the thyroid gland or outside it and whether it is a cyst or a soft tissue nodule. Cysts are almost always non cancerous (benign), although in some cases the fluid may be taken out by a needle under ultrasound guidance for additional testing.

Testicular ultrasound is an imaging technique used for the diagnosis of suspected abnormalities of the scrotum. It is the primary imaging method used to evaluate problems of the testicles and surrounding tissues. It is used when a patient has pain or feels a lump in the scrotum. Other indications for an ultrasound scan include an absent or undescended testicle, inflammation, testicular torsion (twisted testis), fluid collection, abnormal blood vessels or a mass.

Doppler Ultrasound
Doppler is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck. Doppler ultrasound images can help to identify and evaluate blockages to blood flow (such as clots), narrowing of vessels (which may be caused by plaque) and tumors and congenital vascular malformation.

How should I prepare for Ultrasound?

You should wear comfortable, loose-fitting clothing for your ultrasound exam.

You may need to remove all clothing and jewelry in the area to be examined. You may be asked to wear a gown during the procedure.

Other preparation depends on the type of examination you will have.

Emergency Ultrasound
Emergency ultrasounds, e.g. gall bladder colic, kidney stones, aortic aneurysms, deep vein thrombosis and ectopic pregnancies, will be done as quickly as possible. You are not required to fast for the examination, but you should not eat or drink anything without authorization from your doctor or specialist.

Ultrasound Abdomen
Do not chew, eat or drink anything six hours prior to the examination.

Pelvic Ultrasound
Do not chew or eat anything six hours prior to the examination. Drink four glasses of water two hours prior to your exam and avoid urinating so that your bladder is full when the scan begins. It is important to arrive with a full bladder. This allows the sonographer and radiologist to view the bladder while it is full and after it has been emptied. Routine pelvic ultrasound should not be scheduled during menstruation.

Small Parts Or Musculoskeletal
No special preparation unless otherwise instructed by your referring doctor.

How is the Ultrasound performed?

Dr J Veldman - How is the ultrasound performed?

Your ultrasound test is performed by a registered, specially trained sonographer and interpreted by the radiologist. The radiologist may also review the ultrasound with the sonographer.

For most ultrasound exams, you will be asked to lie on your back on a comfortable ultrasound table.

A small amount of water-soluble gel is applied to the area of the body being examined to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing

into your body. The gel does not harm your skin or stain your clothes.

A hand-held instrument, called a transducer, is placed against the gel on your body. The transducer will be moved back and forth across the area being examined. The sonographer will instruct you when, if necessary, to hold your breath to prevent motion on the images.

One or more frames of the moving pictures are typically captured as still images. Once the imaging is complete, the gel will be wiped off your skin.

The radiologist will analyze the images and prepare a signed report for your referring doctor who will discuss the results with you. In some cases the radiologist may discuss results with you at the conclusion of your examination.

Most ultrasound examinations are completed within 30 - 60 minutes.

What will I experience during and after the Ultrasound?

Most ultrasound examinations are painless, fast and easy to perform.

In some ultrasound studies, the transducer is attached to a probe and inserted into a natural opening in the body. These exams include:

Transrectal ultrasound: The transducer is inserted into a man's rectum to view the prostate.

Transvaginal ultrasound: The transducer is inserted into a woman's vagina to view the uterus and ovaries.

Ultrasound exams in which the transducer is inserted into an opening of the body may produce minimal discomfort.

After an ultrasound examination, you should be able to resume your normal activities immediately.

OBSTETRICAL ULTRASOUND

What is an Obstetrical Ultrasound?

Obstetrical ultrasound is a useful clinical test to establish the presence of a living embryo / fetus, estimate the age of the pregnancy, diagnose congenital abnormalities of the fetus, evaluate the position of the fetus, evaluate the position of the placenta, determine if there are multiple pregnancies, determine the amount of amniotic fluid around the baby, check for opening or shortening of the cervix or mouth of the womb, assess fetal growth, assess fetal well-being and to determine the due date.

A number of scans are done.

Early Pregnancy Ultrasound
Done at: The first 10 weeks.

Dr J Veldman - What is an Obstetrical Ultrasound?

Purpose of the scan: This scan determines a live pregnancy, location of the pregnancy (in case it is out of the uterus – an ectopic pregnancy) and can pick up multiple pregnancies.

Dr J Veldman - What is an Obstetrical Ultrasound?

Dating Ultrasound
Done at: 11 – 14 weeks.
Purpose of the scan: Most accurate time to determine the gestational age by ultrasound. The same scan will be performed as in the early pregnancy, but a Nuchal translucency (fluid filled space at the back of the foetus´s neck) measurement can also be done. This is an important chromosome screening test done in conjunction with a blood test (performed by your referring doctor). With this test the risk for conditions such as Down´s syndrome can be determined.

Anomaly Ultrasound
Done at: 20 weeks.
Purpose of the scan: Growth measurements are

done. Detailed anatomical scan to check for structural abnormalities will be performed. The gender of the foetus can also be determined.

Late / Third Trimester Ultrasound
Done at: 28 weeks to term.
Purpose of the scan: Evaluates the foetal growth and to estimate the fetal weight. Confirm the presentation of the foetus (fetal position). To verify the position of the placenta.

How should I prepare for the Obstetrical Ultrasound?

You should wear comfortable, loose-fitting clothing for your ultrasound exam.

4 to 14 Weeks Pregnant If an ultrasound is ordered by your doctor early in your pregnancy, you may be instructed to have a full bladder for the procedure. Air interferes with sound waves, so if your bladder is distended, the air-filled bowel is pushed out of the way by the bladder and an image of the uterus and embryo or fetus is obtained. Drink four glasses of water two hours prior to your exam and avoid urinating so that your bladder is full when the scan begins. It is important to arrive with a full bladder.

14 Weeks to full term No special preparation needed.

How is the Obstetrical Ultrasound performed?

Dr J Veldman - How is the Obstetrical Ultrasound performed?

An Obstetrical ultrasound is performed much like a normal ultrasound.

Sometimes the radiologist determines that a transvaginal scan needs to be performed to obtain more detailed images. This method of scanning is especially useful in early pregnancy.

Transvaginal ultrasound is usually performed with the patient lying on her back - much like a gynecologic exam and involves the insertion of the transducer into the vagina after the patient empties her bladder.

The tip of the transducer is covered with a protective cover and a small amount of gel is used as lubrication. The images are obtained from different orientations to get the best views of the uterus and ovaries.

Obstetric ultrasound cannot identify all fetal abnormalities. Consequently, when there are clinical or laboratory suspicions of a possible abnormality, a pregnant woman may have to undergo other testing such as amniocentesis (the evaluation of fluid taken from the sac surrounding the fetus) to determine the health of the fetus.

What will the Ultrasound Examination cost?

Most medical aids will cover the cost of Ultrasound provided that you have not exceeded your annual imaging limit. Pre- authorization is usually not required by medical aids, but please consult with your medical aid if you are uncertain.

Private patients who pay immediately with cash or with Master or Visa Cards will be charged medical aid rates.

The account remains your responsibility.

In the event of non – payment by your medical aid, you will be held liable for the account and it should be paid within 30 days.

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