Acquiring the basic skill of ultrasound scanning requires the ability to visualize the two-dimensional image as a three-dimensional structure and to develop hand-eye coordination. Different levels of skill are acquired with time depending on the ultrasound investigation and caseload mix, but supervision is essential to avoid blunders. Some individuals acquire competence more quickly than others and yiur supervisor will decide when you are competent to report independently.

Let's get ready to scan

Please sir how can one make a career out of radiography or ultrasound

Good afternoon Chidi4eze..... You want to make a career in sonography..... there are few questions I need to ask... at first.... what is your educational profile as at now. thanks

Let's quickly talk about basic ultrasound instrumentation.
Understanding ultrasound image requires knowledge of sound propagation, production and interaction characteristics. Images are created using pulse echo mode format of ultrasound production and detection. A number of basic components comprise the ultrasound system; the pulse generator, transducer, amplifier, scan converter, image memory, image display, recording system and control panel.
In medical diagnostic ultrasound the primary interest is the detection of the reflected echoes form various interfaces in the body.

There are three basic requirement, generation of ultrasound beam, reception and amplification of returning echo and finally processing of signal for display. All types of ultrasound securing equipment have same basic features.

In the generation of an ultrasound beam... the first requirement of an ultrasound scanner is that a sound wave at ultrasonic frequencies must be generated.

The primary objectives are to produce unidirectional beam, a beam of uniform intensity, and a beam of limited dimension so that a good spatial resolution is obtained.

The transducer assembly transmits a pulse ultrasonic beam into the patient's body. The beam undergoes various interactions and when interface is encountered a fraction of ultrasonic beam is reflected back towards the transducer. The transducer acting as a receiver mode, then a transmitter connects the ultrasound wave (returning echo) to an electronic signal that is processed and displayed.

yinkatolu16:
Good afternoon Chidi4eze..... You want to make a career in sonography..... there are few questions I need to ask... at first.... what is your educational profile as at now. thanks

bsc Human physiology

INTRODUCTION TO REAL-TIME ULTRASOUND
2D ultrasound imaging is performed with earlier static B mode gray scale unit or real -time gray scale scanner.

In real-time scanning the displayed image is continuously and rapidly updated with new scan data as beam swept repeatedly throughout the field of view. For the past twenty years, the primary ultrasonic imaging modality has been static contact B scanning. However for ten years down the line, there has been tremendous increase in the use of real time ultrasound equipment and now real -time ultrasound have technique that has almost totally replaced static B mode gray- scaling imaging.

The increase use of real-time imaging is the result of advances in transducer technology, miniaturization of electronics through the development of digital circuitry, advances in computer software and improved focusing.

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INSTRUMENTATION
The most classification of real-time imaging system is based on the method by which ultrasound beam is swept through the region of interest. There are two major classes of scanner for producing real-time ultrasound images. They are known as (1) mechanical scanner (2) electronic real-time scanner.

Mechanical real-time system uses one or more piezoelectric crystal attached to a stepping motor which moves the crystal to various locations. The changing position of crystal allows scan data to be collected from multiple lines of sight. These scanners may be of either contact scanner or liquid path scanner. Contact scanners are those in which transducer makes physical contact with the patient. Mechanical scanners are further classified into wobbler type or rotating wheel type and spinner type or oscillating type.
All produce an image with sector formats usually encompassing an arc between 45 degree and 90 degree. The disadvantage of sector scanner is that scan format is relatively fixed for any transducer.

Electronic Scanner
In this group of scanner there is no mechanical moving compartment and ultrasound beam is scanned through the imaging plane by purely electronic mean. Electronic real-time scanners are classified into linear and phased array or steered array.

Linear array transducer produces rectangular scan format. They can be straight or curved also. General purpose linear array transducer comprises a strip of piezoelectric material approximately 1.5 to 2.0cm in width and 10 to 12 cm in length. This is divided into large number of small strip typically up to 600 in a modern transducer. Linear array transducer may 've of three types 1. Sequential linear array
2. Segmental array
3. Sequential and segmental.

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Pelvic scanning
The instructions generally given is that you should drink glasses of fluid perhaps water about one hour preceding the scanning. Though this is variable, generally more fluid is required in the morning because of relative dehydration due to an overnight sleep than for bookings in the afternoon. Filling the bladder has several advantages; as it provides an acoustic window, straightens the axis of the uterus and demonstrates the relationship of uterine fundus to ovaries.

It is useful in documenting bladder emptying to remove back pressure on kidneys, to demonstrate pelvic masses and to avoid confusion between large pelvic cyst and urinary bladder and to visualize side walls of pelvis.

However, over full bladder may disturb pelvic anatomy, may make gestational sac appear irregular and flattened. Produces a falsely elongated cervix and a falsely low lying placenta.

The aims of early pregnancy scanning are to determine: 1. Viability
2. Gestational age
3. Fetal number.
In addition, the adnexa should be visualized to exclude significant pathology. Measurement of the CRL..... crown- rump length of the embryo in the first trimester has shown to be the most accurate parameter for assessment of gestational age. This is because in the first trimester, there is little biological variation seen in the measurement taken in different patients at the same gestation and the percentage increase in size in a week is greatest at this time.

For obstetrics ultrasound use 3.5 or 5.0MHz linear or convex focused of 7-9cm. The 5.00MHz transducer is best during early pregnancy.

Note that gestational age is always based on completed weeks from the first day of the L. M. P.

In a patient with a normal 28-day menstrual cycle, ovulation occurs on day 14 and conception very soon thereafter. Embryonic age therefore tends to be 2weeks less than gestational age.

The patient should have a full bladder to aid identification of the uterus, especially before 10weeks when the uterus is still well within the pelvis.

If the bladder is empty, a transvaginal scan will be required unless the patient is very thin. The uterus is difficult to identify in the obese patient or when it is in a retroverted position. Pals.... if you cannot define the uterine cavity transabdominally, a transvaginal scan will reveal all.

Identify an intrauterine gestation sac with a fetal pole and a fetal heart(FH) pulsation. Viability is confirmed when the heart pulsation is seen.

The earliest time at which the heart pulsation can be seen is 5weeks when the embryonic length is 2-4mm, but in 10% of viable pregnancies a pulsation will still not be visible.

Scan the whole uterine cavity from top to bottom and side to side to make sure there is only one fetus and that the outline of the sac appears smooth. You will miss multiple pregnancy if you omit this step.

Also you should look at the uterine wall to exclude fibroids, uterine abnormality and also look at the adnexa to exclude ovarian cysts.