Wednesday, November 18, 2009

Ultrasound & Sonography Specializations

As sonography has proven to be a safe, accurate and versatile form of medical imaging, the variety of uses for it has expanded to the point that ultrasound technicians may often choose to specialize in one or perhaps two specific areas. Here are the principal areas of specialization as currently defined in ultrasound medical imaging.

Vascular Sonography

Medical sonographers who specialize in vascular ultrasound may apply their skills to tests that involve the arteries, veins and capillaries that are used to move blood around the body. One of the more frightening conditions that may be caused by a blood clot is the pulmonary embolism, a clot that develops in the main artery between the lungs and the heart. There are some situations where the vascular sonographer may become involved in cardiopulmonary examinations or procedures.

Vascular ultrasound scans are looking for clots or other arterial blockages more often than anything else. An ultrasound procedure for arterial blockage, for instance, may not only look for a small mass of material within an artery, it may also measure the pace of blood flow as it moves through arteries and veins.

The sonography equipment used for this type of study is called Doppler ultrasound. It is designed so that the sound waves measuring blood flow change in tone when movement of blood cells is detected. These “pings” are translated into visual presentations by the ultrasound computer.


Neurosonography generates diagnostic images of the nervous system, including the brain. Neurosonographers often work in the area of neonatal care, examining, studying and diagnosing conditions of the neurological and nervous system of premature infants. This is once again an important advancement of medical technology, because the use of X-rays with neonates has always been a concern.

Echoencephalography is the study of the brain’s tissue and structure with ultrasound, which has become an important tool in neurology. Image guidance has also become a standard feature of several neurological medical procedures and often ultrasound is the image technology of choice. Cranial surgical procedures utilize ultrasound real-time imaging that may provide a picture of the surgical tools and the patient from any angle that the surgeon requests.

Neurosonography may also be used to guide the application of regional anesthetics for procedures that are being conducted close to important nerves or nerve clusters. A physician conducting a shoulder operation, for instance, may use ultrasound images to determine exactly where an anesthetic syringe or catheter pumping local anesthetic should be placed.

Abdominal Sonography

Abdominal sonographers generally produce images of an organ or organ system within the patient’s abdominal cavity. This specialty incorporates a variety of examinations, a list that is growing as additional techniques develop. There are a lot of organs in the abdominal cavity, which means there are a lot of medical issues that arise in this part of the body.

An ultrasound examination of the liver and bile ducts may be searching for blockages, for a tumor, or for evidence of disease. The pancreas and spleen are examined for inflammation – one of the most painful and dangerous afflictions in this area is pancreatitis. For the kidneys, the gallbladder and the thyroid ultrasound procedures may involve the use of a medium that is injected and moves through the organ under study to highlight abnormalities.

Ultrasound technology is also used to assist in biopsy procedures, particularly in the abdominal area where there are so many organs clustered together. An ultrasound machine that is focused tightly on a particular organ or portion of an organ can help guide the biopsy process along with the endoscope operated by the physician. Ultrasound images can help the physician to see and evaluate:


Echocardiographers are ultrasound technologists who study the heart, its chambers, valves and vessels. EKG’s, stress testing and Holter monitor procedures were developed to analyze electrical signals given off by the heart. Today those tests are augmented or in some cases replaced with the use of sonography.

These are three common tests that are conducted on a daily basis in clinics and hospitals that treat heart patients. Cardiovascular disease may be the cause of many death in this country; angiograms, angioplasties and heart bypass procedures are everyday occurrences in surgically equipped hospitals. An ultrasound machine may provide important imaging support for all of these procedures. Echocardiography is used in a multitude of tests that examine heart activity and blood flow from several physical angles and from the standpoint of blood flow impact on other organs such as the lungs.

The echocardiogram complements the electrocardiogram at the moment – one day ultrasound may supplant the traditional echocardiogram – or perhaps the two technologies may be merged through technology into a single test.

Obstetrics and Gynecology (OB/GYN)

Ultrasound images are used by obstetricians with pregnant patients to study the position of the fetus and the position of the placenta – these images (or exams using live pictures) are preparation for the child’s birth. They also, famously, may determine the child’s gender.

Ultrasound exams determine the possibility of multiple births and ascertain the amount of amniotic fluid protecting the fetus. For these and other pelvic exams, the sonographer uses a transducer – a handheld device that is passed over the pelvic area and returns images to a computer screen immediately.

Pelvic sonography for women that does not involve pregnancy may be conducted to evaluate the bladder, the fallopian tubes, the ovaries, the uterus or the cervix. Symptoms that lead to these exams may include pelvic pain, abnormal bleeding or menstrual problems. Ultrasound images help identify ovarian cysts or any tumors that may be found in the ovaries or the uterus.

Breast Sonography

Breast Sonography has become a specialty because it has emerged as an important tool in the fight against breast cancer. Ultrasound images of the breast tissue and blood supply are standard procedure today for tumor detection. Breast ultrasound is often partnered with mammography using X-rays and/or MRI procedures that may focus with precision on a very small area.

Unlike other forms of imaging, ultrasound can help to determine if a breast abnormality is solid (which may be either a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (such as a benign cyst) or both cystic and solid. Ultrasound may also be utilized to evaluate the flow of blood through the area using Doppler technology, which provided real time images of blood or other fluids through the body.

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