Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. Obstetric sonography is commonly used during pregnancy and is widely recognized by the public. There are a plethora of diagnostic and therapeutic applications practiced in medicine.

In physics the term "ultrasound" applies to all acoustic energy with a frequency above human hearing (20,000 hertz or 20 kilohertz). Typical diagnostic sonographic scanners operate in the frequency range of 2 to 18 megahertz, hundreds of times greater than this limit. The choice of frequency is a trade-off between spatial resolution of the image and imaging depth: lower frequencies produce less resolution but image deeper into the body.

Sonography (ultrasonography) is widely used in medicine. It is possible to perform diagnosis or therapeutic procedures with the guidance of sonography (for instance biopsies or drainage of fluid collections). Sonographers are medical professionals who perform scans for diagnostic purposes. Sonographers typically use a hand-held probe (called a transducer) that is placed directly on and moved over the patient. A water-based gel is used to couple the ultrasound between the transducer and patient.

Sonography is effective for imaging soft tissues of the body. Superficial structures such as muscles, tendons, testes, breast and the neonatal brain are imaged at a higher frequency (7-18 MHz), which provides better axial and lateral resolution. Deeper structures such as liver and kidney are imaged at a lower frequency 1-6 MHz with lower axial and lateral resolution but greater penetration.

Medical sonography is used in, for example:

  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Gynaecology; see gynecologic ultrasonography
  • Obstetrics; see obstetric ultrasonography
  • Ophthalmology; see A-scan ultrasonography, B-scan ultrasonography
  • Urology, to determine, for example, the amount of fluid retained in a patient's bladder.
  • Musculoskeletal, tendons, muscles, and nerves
  • Vascular, arteries and veins
  • Intravascular ultrasound (e.g. ultrasound guided fluid aspiration, fine needle aspiration, guided injections)
  • Intervenional; biopsy, emptying fluids, intrauterine transfusion (Hemolytic disease of the newborn)
  • Contrast-enhanced ultrasound
  • A general-purpose sonographic machine may be able to be used for most imaging purposes. Usually specialty applications may be served only by use of a specialty transducer. The dynamic nature of many studies generally requires specialized features in a sonographic machine for it to be effective; such as endovaginal, endorectal, or transesophageal transducers.

Sonograph showing the image of a fetal head in the wombObstetrical ultrasound is commonly used during pregnancy to check on the development of the fetus.

In a pelvic sonogram, organs of the pelvic region are imaged. This includes the uterus and ovaries or urinary bladder. Men are sometimes given a pelvic sonogram to check on the health of their bladder and prostate. There are two methods of performing a pelvic sonography - externally or internally. The internal pelvic sonogram is performed either transvaginally (in a woman) or transrectally (in a man). Sonographic imaging of the pelvic floor can produce important diagnostic information regarding the precise relationship of abnormal structures with other pelvic organs and it represents a useful hint to treat patients with symptoms related to pelvic prolapse, double incontinence and obstructed defecation [1]

In abdominal sonography, the solid organs of the abdomen such as the pancreas, aorta, inferior vena cava, liver, gall bladder, bile ducts, kidneys, and spleen are imaged. Sound waves are blocked by gas in the bowel, therefore there are limited diagnostic capabilities in this area. The appendix can sometimes be seen when inflamed eg: appendicitis.

Therapeutic Applications

Therapeutic applications use ultrasound to bring heat or agitation into the body. Therefore much higher energies are used than in diagnostic ultrasound. In many cases the range of frequencies used are also very different.
  • Ultrasound may be used to clean teeth in dental hygiene.
  • Ultrasound sources may be used to generate regional heating in biological tissue, e.g. in occupational therapy, physical therapy and cancer treatment.
  • Focused ultrasound may be used to generate highly localized heating to treat cysts and tumors (benign or malignant), This is known as Focused Ultrasound Surgery (FUS) or High Intensity Focused Ultrasound (HIFU). These procedures generally use lower frequencies than medical diagnostic ultrasound (from 250 kHz to 2000 kHz), but significantly higher energies. HIFU treatment is often guided by MRI.
  • Focused ultrasound may be used to break up kidney stones by lithotripsy.
  • Ultrasound may be used for cataract treatment by phacoemulsification.
  • Additional physiological effects of low-intensity ultrasound have recently been discovered, e.g. its ability to stimulate bone-growth and its potential to disrupt the blood-brain barrier for drug delivery
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