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Salus sonography

Our focus is in everything about ultrasound: articles, guidelines, tables and flowcharts!

Our purpose is to share worldwide some tips, skills and knowledge in Diagnostic Sonography!

08/02/2023

- Diagnostic imaging techniques are superior to clinical examination in determining the size of the liver.

- To date, however, there is a paucity of data regarding normal and borderline values, and no uniform procedure for measuring the size of the liver has been established that can
serve as a guideline for ultrasound examination of the liver.

- In this post we share a reliable technique for measuring the hepatic lobes and the reference values used as normal for both lobes.

- If this post was useful, don’t forget to share with someone who might benefit from it.

06/02/2023

- As you have requested, Spiegel's hernia report was the most voted in the last post we have shared.

- Leave a comment if this content was useful.

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01/02/2023

Would you like to see a post about abdominal wall ventral hernias>

Share you opinion in the comments below!

26/01/2023

The many faces of Hashimoto's Thyroiditis at ultrasound.
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19/01/2023

Traction of the re**us abdominis muscles can lead to a widening of the linea alba, causing a clinical condition known as diastasis of the re**us abdominis muscles (DRAM).

DRAM is characterized by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to “bulge’’ when intra-abdominal pressure is increased. This clinical condition is often seen in pregnancy.

According to the Beer classification, DRAM is defined as an interre**us distance (IRD) of 22 mm or more, assessed three centimeters above the umbilicus.

This measure must be taken in a relaxed state of the patient, avoiding traction that can make muscles to get closer to each other.

Although the association is not definitive, the presence, size, and duration of DRAM have been linked to pelvic and low back pain.

Ultrasound and calipers are satisfactory tools for DRAM measurement. It has been most widely researched with regard to its reliability and has shown to be a reliable method when images were taken by experienced sonographers/sonologists. Calipers also seem a reliable method for measuring DRAM width.

Did you like this content? Leave it in the comments so we know if we're on the right track.

17/01/2023

Although the most accurate method for measuring testicular volume is still debated, ultrasound is generally recognized as the most reliable for measuring testicular volume in practice.

Ultrasonography is used as a standard for comparing different techniques for measuring testicular volume. However, some authors found great variability based on the examiner and the formula used.

Among the commonly used US formulas, the empirical formula of Lambert (L × W × H × 0.71) provided better accuracy than the other formulas, demonstrating that its use should be prioritized in clinical practice.

And you, which formula do you use to evaluate testicular volume? Let us know in comments below.

13/01/2023

Many colleagues already know that the correct position of the IUD evaluated by ultrasound is when we visualize the device above the internal os of the uterine cervix.

However, little or nothing is said about how to evaluate the internal os with ultrasound.

Therefore, I would like to share a practical tip about how to recognize the internal os of the cervix through the cervical glandular echo.

If you want more tips like this one, leave a comment with “yes”!

09/01/2023

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# #ультразвук #узищитовиднойжелезы #эндокринология

06/01/2023

📝 ROLE OF ULTRASOUND REPORT ON DIVERTICULITIS

- In contrast to the United States, sonography is used as the first- line imaging modality in some European countries and most developing countries.

With the recent technological advances of the sonographic machines that are available today, the ever-improving resolution, and the ability to visualize the various charac- teristics of echo architecture that accompany spreading transmural inflammation, sonography is emerging as a premier modality for the imaging of the gastrointestinal tract.

📝 SONOGRAPHIC FEATURES OF ACUTE DIVERTICULITIS

- Several key sonographic features have been described in acute diverticulitis and must be observed to an adequate ultrasound report description:

1️⃣ A thick hypoechoic wall with a central hyperechoic center (target phenomena), which is seen in up to 40% of cases. Although it was one of the initial sonographic signs described for the diagnosis of ACD, later studies have found it to be nonspecific.Thus, the primary emphasis is placed on a thickened hypoechoic wall.

2️⃣ Diverticula, which are seen in up to 50% of cases

3️⃣ Changes in pericolic fat. This sign is usually seen as a rigid hyperechoic zone surrounding the colon, representing omental or pericolic fat that is encasing the inflammation.

4️⃣ Enlarged fluid-filled loops of bowel.

5️⃣ Air-containing diverticula manifesting as hyperechoic areas within the lumen where there is acoustic shadowing as a result of air residue.

6️⃣An abscess presenting primarily as a cystic mass with hyperechoic debris.

7️⃣Local pain and tenderness on compression.

⚠️ The ultrasound report needs to emphasize if the diverticulitis findings are of an uncomplicated condition or if there is the possibility of some complication or even any limitation of the examination that indicates the need for another complementary method such as computed tomography.

04/01/2023

Would you like to see an ultrasound report for diverticulitis?
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30/12/2022

A complete hydatidiform mole (CHM) is a type of molar pregnancy and falls at the benign end of the spectrum of gestational trophoblastic disease.

In 90% of cases, complete hydatidiform mole (CHM) arises when an empty o**m that lost its maternal chromosomes is fertilized by one s***m, which then duplicates its own DNA, resulting in a “complete” 46-chromosome set.

In 15-20% of the cases, complete hydatidiform mole may result in gestational trophoblastic neoplasia, with invasive mole being the most common form of persistent of gestational trophoblastic disease.

Clinically, patients with complete hydatidiform mole are often diagnosed early in gestation and are often asymptomatic at the time of diagnosis. Common presenting symptoms include vaginal bleeding, usually at 6–16 weeks gestation, large-for- date uterine size, and hyperemesis. CHM are commonly associated with a markedly elevated β-hCG level.

📝ULTRASOUND FINDINGS OF COMPLETE HYDATIDIFORM MOLE

US remains the imaging modality of choice for initial evaluation of molar pregnancy. These tumors may be incidentally discovered in asymptomatic patients undergoing routine first-trimester US or patients with clinically suspected molar pregnancy who present with vaginal bleeding or β-hCG titers higher than expected for gestational age.

The remarkable ultrasound features of CHM during the first trimester is an enlarged uterus filled with a heterogeneous predominantly echogenic mass with several cystic spaces. This is described as the “cluster of grapes” appearance and is due to hydropic chorionic villi.

It’s important to highlight that in complete mole fetal parts are absent. Another findings as multiple large, bilateral, functional ovarian cysts called theca lutein cysts are seen in less than 20% of cases of CHM.

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26/12/2022

The main purpose in evaluating a cesarean scar (CS) defect involves measuring the healthy myometrium adjacent to CS defect, the scar myometrium and the defect itself.

In this scenario, our report must include the following measurements (in midsagittal uterine scan):

1. CS scar should be measured in at least two dimensions (width and depth)
2. Residual myometrium (B) is measured as the shortest visible distance from the delineation of the endometrium to the serosal surface at the level of the CS scar.
3. The myometrial thickness (A) adjacent (fundal) to the scar.

Reporting the measurements in isthmocele is fundamental in the classification and management of these patients.

Did you like this report model for isthmocele? Leave a comment below.

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