How should the discovery of ultrasonic be described?

Normally, when people look at the results of an ultrasound, they kind of wonder what they are looking at. This complexity also stretches to understanding which side is up and deciding what the ultrasound is all about. Thus, reading ultrasound does involve first understanding what the basics are, and then applying them to the produced image.

By definition, ultrasound is considered a non-invasive, immediate device that is utilized for taking images of tissues. It does not pierce through the bone as X-rays would normally do. Thus, the first step to reading the results of an ultrasound is to acclimatize one’s self with the anatomy that is being imaged (Varra, 2012)—as the absence of such will definitely cause a certain level of unwanted dilemma in the process of reading them.

Figure 1: Ultrasound Image Reading

Different body tissues have been known to conduct sound differently. For instance, some tissues are known to absorb waves while others are known to reflect them. The density of the tissue being imaged does dictate the speed at which the echo will be returned. Secondly, it should be noted that fluids are always black, while tissues are always gray (Group Dynamic Ultrasound, n.d.). The thicker a tissue is, the brighter the result of the ultrasound will be, and the brightest (most white) of the tissue is bone.

Thus, once an ultrasound result is presented, it can easily be referenced by referencing the color of the image in the sense that white areas indicate bones, grey areas indicate tissues, and dark areas indicate fluids.

The different positions to use when questioning gallbladder pathology and its importance

Cholelithiasis is a known pathological feature of stones or calculi that are contained inside the lumen of a gallbladder (Brunetti, 2015). This is a very common digestive disorder in the world.

Figure 2: Gallbladder Ultrasound

In order to discover these health issues, ultrasound (US) is normally used as the method of choice when detecting gallstones. At present, real-time, high-resolution ultrasounds have been known to identify gallstones that are as little as 2 mm, having a sensitivity that is found to be greater than 95%. This technique is both non-invasive and rapid and can be achieved at the bedside; it doesn’t require ionizing radiation (Brunetti, 2015). Only 15-20% of stones are visible on plan radiography, indicating the need for new questions to be asked at different positions of the gallbladder.Different sections of the gallbladder should be reviewed to search for any potential stone development.

In an opacified gallbladder, it is possible to miss calcified stones, which can result in a side effect on the contrast. False negativities can also occur on intrasonograms in cases where "little stones" develop in the company of biliary sludge. Additionally, ultrasound results are dependent on the operators, with insufficient imagining of the gallbladder likely to occur in contracted or obese patients or in patients that have abdominal sounds (Healthline Medical Team, 2014). Thus, these are the main reasons why the different positions of the gallbladder should be questioned in order to ensure that there are no health issues being misplaced.

UNDERSTANDING POSITIVE SONOGRAPHIC MURPHY'S SIGN

In terms of its definition, sonographic Murphy's sign (SMS) is a maximal abdominal tenderness that occurs due to pressure from the ultrasound probe passing over the visualized gallbladder (Khan, 2015). It is also described as a sign of a local inflammation occurring around the gallbladder, together with the right upper quadrant pain, mass, or tenderness.

This is one of the most important sonographic signs of cholecystitis, and when combined with the absence or presence of cholelithiasis, it produces high negative and positive predictive values (Luijkx & Knipe, n.d.).

Acute cholecystitis (AC) is caused by inflammation of the gallbladder wall, and it normally occurs because of the cystic duct being obstructed. In 90% of recorded cases, it has been found that the AC is inflated due to the impact of a calculus within the neck of the gallbladder or inside the cystic duct (Luijkx & Knipe, n.d.).

DIFFERENTIAL DIAGNOSIS AND IMAGING TO DO IN ORDER TO RULE OUT ADDITIONAL PATHOLOGY

Although ultrasound has been found to be successful in medical pathology, there are concerns that the rays produced from the process can have negative effects on the overall health of the patient. Thus, the demand for alternatives has increased recently, but the choice of alternatives is generally influenced by the case being diagnosed (Beachy, 2014). That is to say, the alternative for pregnant women might not be the same for young children suffering from appendicitis. In any case, there are general alternatives as discussed below.

Routine scanning is the traditional method of detecting imbalances or foreign objects in the body.There are different tests that can be run to detect different diseases and imbalances in the body (Beachy, 2014). For instance, women who are at the risk of miscarriage can actually choose fertility charting and specifically track the temperature of their basal body in order to determine whether a miscarriage is imminent in the first week of their pregnancy. (Beachy, 2014).

Furthermore, expectant mothers may be compelled to know the sect of their fetus or identify potential chromosomal abnormalities (an ultrasound-based pathology).This can be done in their first trimester with only a blood draw, a new relative test that is sensitive enough to detect fetal DNA in the maternal blood sample with an accuracy level of 98%. For this purpose, skilled midwives and healthcare practitioners have been trained to make use of invasive procedures and other tools like the pinard horn to monitor fetal heart rate (Modern Alternative Pregnancy, n.d.). The measurement of fundal height is considered as effective as ultrasound in the course of monitoring normal fetal growth rate throughout the course of the entire pregnancy, and experienced practitioners can actually provide a highly accurate determination of the fetal positions in the course of the third trimester of the said pregnancy (Modern Alternative Pregnancy, n.d.).

Essentially, it is clear that routine tests are still a viable option to ultrasound pathology for those that are looking to avoid the potential effects of such. However, it is important to note at this point that ultrasound pathology is much more accurate.

References

Beachy, D. (2014, November 19). When Is an Ultrasound Alternative Better for Appendicitis?http://www.healthimaging.com/topics/diagnostic-imaging/ultrasound-alternative-when-it-is-better-choice-appendicitis

Brunetti, J. C. (2015, October 27). Imaging in Gallstones (Cholelithiasis) Medscape, http://emedicine.medscape.com/article/366246-overview

Group Dynamic Ultrasound (n.d.). Physics, instrumentation, and basic techniques Dynamic Ultrasound Group (http://dynamicultrasound.org/dugphysics.html)

Healthline Medical Team. (2014, December 3). gallbladder Health Line (http://www.healthline.com/human-body-maps/gallbladder)

Khan, A. N. (2015, 10/10). Acute Cholecystitis Imaging Medscape, http://emedicine.medscape.com/article/365698-overview

Luijkx, T., & Knipe, H. (n.d.). Sonographic Murphy's sign. Radiopaedia article: https://radiopaedia.org/articles/sonographic-murphy-sign-1

Modern Alternative Pregnancy (n.d.). Ultrasound. Retrieved from http://www.modernalternativepregnancy.com/2015/10/13/fetal-ultrasound-risks-benefits-and-alternatives-part-ii/.

Varra, M. (2012, 3 27). Ultrasound Basics; How to read an ultrasound image. Retrieved from E.I. Medical Imaging Portable Ultrasound Solution Blog: http://www.eimedical.com/blog/bid/76503/Ultrasound-Basics-How-to-read-an-ultrasound-image