Clinical Applications

In alphabetical order, the clinical applications of ultrasound are steadily increasing.

 

ANESTHESIA – SURGERY

Ultrasound takes the guesswork out of line placements, cannulation, regional anesthesia, and other common anesthesia procedures.   Other uses by anesthesiologists include:

  • Central line placements - locate vascular structures in the neck, upper chest, upper arms, and legs for cannulation, minimizing patient discomfort and avoid erroneous punctures
  • Regional nerve blockades -- visualize peripheral nerves and nearby vasculature so the block is effective, accidental venous or arterial punctures are avoided and anesthetic usage is minimized
  • Transesophageal Echocardiography (TEE) - for assessment of intra-operative cardiac function, including wall motion, ventricular function, and flow dynamics
  • Transthoracic echocardiography -- identify cardiac pathologies, including mitral and aortic valve function and pericardial fluid, quickly and effectively
  • Critical care - assess pericardial or pleural effusion and place lines more efficiently

 

CARDIOLOGY
Enables the user to evaluate cardiac anatomy and functionality of the heart including:

  • Effectively identifies cardiac pathologies, including valvular disease and left ventricular function.
  • Determines heart size and quantifies both heart and valvular function to assess disease process and monitor progression
  • Intima-media thickness (IMT) measurements of common carotid arteries for assessment of cardiovascular disease progression and risk
  • Guide cardiac surgical procedures such as coronary bypass, valve repair or replacement, and closure device placement within the septum

 

CRITICAL CARE
provide intensivists with the answers they need in a fast-paced, space-constrained critical care environment. Ultrasound can assess specific emergent conditions and perform needed assessments without delay. Here are some of the ways ICU and CCU departments are using ultrasound systems:

  • Central venous catheter guidance - Accurately and safely place lines, even in hypotensive patients
  • Transthoracic echocardiography - quickly and effectively identify cardiac pathologies, including mitral and aortic valve function and pericardial fluid
  • Assess Left Ventricular function
  • Detect pericardial tamponade

 

ENDOCRINOLOGY
Endocrinologists are using ultrasound for the following:

  • Visual characterization or identification of thyroid nodules - determine vascularity of lesions
  • Guiding percutaneous needle core biopsy of thyroid - ensures more accurate sampling
  • Guiding fine needle aspiration (FNA) of cysts - get it right the first time

 

EMERGENCY MEDICINE
Emergency departments are purchasing for the following:

  • Detect free fluids - Focused Abdominal Sonography for Trauma (FAST) imaging of the four quadrants of the abdomen to determine the need for immediate treatment or transfer to the OR
  • Identify pneumothorax or hemothorax, and guide the placement of chest tubes
  • Accurately and safely place central lines in hypotensive patients
  • Evaluate organs for injury from trauma

 

MUSCULOSKELETAL
Ultrasound is user to diagnose, monitor and provide intervention for a broad range of musculoskeletal conditions such as:

  • Ensuring accurate injections
  • Guiding aspirations
  • Rapidly diagnosing common sports injuries
  • Enabling the detection of RA at its earliest stages

 

OBSTETRICS/GYNECOLOGY
Here are some of the ways obstetricians and gynecologists are using ultrasound

  • Fetal growth assessment with published fetal biometry tables
  • Anatomical assessment of fetus
  • Confirmation of fetal position and assessment of amniotic fluid volume
  • Confirmation of fetal viability
  • Biophysical profile scoring
  • Assessment of uterus and ovaries
  • Guidance for interventional procedures

PRIMARY CARE
Here are some of the ways primary care physicians are using  ultrasound systems

  • Abdominal Aortic Aneurysm screening and measurements
  • Assess gallbladder for presence of stones
  • Complete assessment of intima-media thickening of the common carotid wall as a marker of cardiovascular disease progression and risk for future cardiovascular events
  • Provide ultrasound guidance for abscess aspiration
  • Complete simple binary assessments of cardiac function
  • Follow-up evaluation of graft integrity

 

INTERVENTIONAL RADIOLOGY
Ultrasound-guided intervention is becoming an increasingly popular and valuable tool in the critical care setting. In general, image-guided procedures can expedite wait times and increase the accuracy, safety, and efficacy of many procedures commonly performed within intensive care units. In the intensive care unit setting, ultrasound has particular advantages over other imaging modalities such as computed tomography and fluoroscopy, including real-time visualization, portability permitting bedside procedures. These include central venous catheter deployment, thoracentesis, paracentesis, and drainage of a wide variety of abscesses, and percutaneous nephrostomy, percutaneous cholecystectomy, and inferior vena cava filter placement. With the improvement of ultrasound technology and the innovation of new ultrasound-guided procedures, the role of ultrasound in the intensive care unit will continue to expand, with bedside ultrasound-guided interventions increasingly becoming the norm.

 

SURGERY
Ultrasound can accurately visualize anatomical structures for better diagnosis.   Here is how Ultrasound  is  used in different surgical specialties:

 

Breast

  • Biopsy and aspiration or excision - locate masses and complete biopsies or other assessments on one visit, alleviating patient anxiety and building physician respect
  • Wire placement and localizations - accurately place the wire or marker the first time

 

Vascular

  • Line placements - locate vessels for placement of central venous catheters; assess bypass grafts; and place A-V grafts for diabetic patients
  • Provides ultrasound guidance for incompetent valve ablation procedures
  • Endarterectomy procedures -- ensure there is no kinking of the carotid artery and flow is normal before closing

 

Trauma

  • Quick imaging of the four quadrants of the abdomen for free fluid, eliminating waiting time for a CT scan and speeding up the time to get the patient to the OR
  • Identify pneumothorax and guide placement of a chest tube to re-inflate the affected lung
  • Accurately and safely place central lines in hypotensive patients

 

UROLOGY
Urologists are using Ultrasound for:

  • Prostate assessment and biopsy
  • Renal assessment and biopsy
  • Testicular mass assessment and aspirations
  • Bladder assessment for masses and filling defects
  • Bladder volume assessment

 

VASCULAR
Here are some of the ways vascular specialists are using ultrasound

  • Diagnosis and quantification of carotid and peripheral vascular disease
  • Pre-operative assessment for dialysis access and surveillance
  • Diagnosis and guidance for the treatment of superficial venous reflux disease
  • Common carotid intima-media thickness automatic edge-detection software for cardiovascular risk factor assessment
  • Intra-operative carotid endarterectomy and bypass graft assessment
  • Post-operative surveillance and monitoring
  • Aortic assessment and monitoring
  • Renal artery assessment
  • Portable diagnostic studies

 

VETERINARY(Large and Small Animal)

  • Basic/Int. Abdominal
  • Basic Cardiac
  • Tendon integrity
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