Abdominal ultrasonography (also called abdominal ultrasound imaging or abdominal sonography) is a form of
medical ultrasonography
Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, mus ...
(
medical
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
application of
ultrasound
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
technology) to visualise
abdominal
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...
anatomical
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the
abdominal wall
In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls.
There is a common set of layers covering and forming all the walls: the deepest being the ...
(with the help of gel, which helps transmission of the sound waves). For this reason, the procedure is also called a transabdominal ultrasound, in contrast to
endoscopic ultrasound, the latter combining ultrasound with
endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inse ...
through visualize internal structures from within hollow organs.
Abdominal ultrasound examinations are performed by
gastroenterologists or other specialists in
internal medicine,
radiologist
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiati ...
s, or
sonographer
A sonographer is an allied healthcare professional who specializes in the use of ultrasonic imaging devices to produce diagnostic images, scans, videos or three-dimensional volumes of anatomy and diagnostic data. The requirements for clinical p ...
s trained for this procedure.
Medical uses
Abdominal ultrasound can be used to diagnose abnormalities in various internal organs, such as the
kidneys
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; bloo ...
,
liver
The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it i ...
,
gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
,
pancreas
The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an ...
,
spleen
The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes . and
abdominal aorta
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax).
Structure
The abdominal aorta begins at the level of the diaphr ...
. If
Doppler ultrasonography
Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of a ...
is added, the
blood flow
Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously m ...
inside
blood vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide awa ...
s can be evaluated as well (for example, to look for
renal artery stenosis). It is commonly used to examine the
uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
and
fetus
A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal dev ...
during
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ...
; this is called
obstetric ultrasonography
Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a stan ...
.
Abdominal ultrasound is commonly used in the setting of
abdominal pain
Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues.
Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. About 15% of people have a m ...
or an
acute abdomen
An acute abdomen refers to a sudden, severe abdominal pain. It is in many cases a medical emergency, requiring urgent and specific diagnosis. Several causes need immediate surgical treatment.
Differential diagnosis
The differential diagnosis o ...
(sudden and/or severe abdominal pain syndrome in which surgical intervention might be necessary), in which it can diagnose
appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a r ...
or
cholecystitis
Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis. The pai ...
.
Ultrasound can also be used if there is suspicion of enlargement of one or more organs, such as used in screening for
abdominal aortic aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, ...
, investigation for
splenomegaly
Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of ''hypersplenism'' which include: some reduction in number of circulatin ...
or
urinary retention.
Ultrasound can be used for additional anatomical information for patients with an abnormal
kidney function or
pancreatic enzyme
Digestive enzymes are a group of enzymes that break down polymeric macromolecules into their smaller building blocks, in order to facilitate their absorption into the cells of the body. Digestive enzymes are found in the digestive tracts of anim ...
s (
pancreatic amylase and
pancreatic lipase).
It can be used on the
abdominal aorta
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax).
Structure
The abdominal aorta begins at the level of the diaphr ...
to detect or exclude
abdominal aortic aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, ...
. For this purpose, the standard aortic measurement for
abdominal aortic aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, ...
is between the outer margins of the aortic wall.
[
In cases of ]infectious mononucleosis
Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV). Most people are infected by the virus as children, when the disease produces few or no symptoms. In young adult ...
, splenomegaly is a common symptom, and health care providers may consider using abdominal ultrasonography to get insight into a person's condition.[, which cites
*
* ] However, because spleen size varies greatly, ultrasonography is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports.
Detecting stones
Ultrasound imaging is useful for detecting stones, for example kidney stone
Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine s ...
s or gallstone
A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of mi ...
s, because they create a clearly visible ultrasound shadow behind the stone.
Ultrasonography can be used to guide procedures such as treatment for kidney stones with Extracorporeal shock wave lithotripsy
Extracorporeal shockwave therapy (ESWT) is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders. ESWT sends acoustic shock waves into bone or soft tissue, in effect reinjuring the area on a cellular l ...
, needle biopsies
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
or paracentesis
Paracentesis (from Greek κεντάω, "to pierce") is a form of body fluid sampling procedure, generally referring to peritoneocentesis (also called laparocentesis or abdominal paracentesis) in which the peritoneal cavity is punctured by a needl ...
(needle drainage of free fluid inside the abdominal cavity).
Liver
In patients with deranged liver function tests, ultrasound may show increased liver size (hepatomegaly
Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdo ...
), increased reflectiveness (which might, for example, indicate cholestasis
Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malig ...
), gallbladder or bile duct
A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates.
Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It ...
diseases, or a tumor
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
in the liver.
Ultrasonography of liver tumors involves two stages: detection and characterization. Tumor detection is based on the performance of the method and should include morphometric information (three axes dimensions, volume) and topographic information (number, location specifying liver segment and lobe/lobes). The specification of these data is important for staging liver tumors and prognosis. Tumor characterization is a complex process based on a sum of criteria leading towards tumor nature definition. Often, other diagnostic procedures, especially interventional ones, are no longer necessary. Tumor characterization using the ultrasound method will be based on the following elements: consistency (solid, liquid, mixed), echogenicity
Echogenicity (misspelled sometimes as echogenecity) or echogeneity is the ability to bounce an echo, e.g. return the signal in ultrasound examinations. In other words, echogenicity is higher when the surface bouncing the sound echo reflects incre ...
, structure appearance (homogeneous or heterogeneous), delineation from adjacent liver parenchyma (capsular, imprecise), elasticity, posterior acoustic enhancement effect, the relation with neighboring organs or structures (displacement, invasion), vasculature (presence and characteristics on Doppler ultrasonography
Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of a ...
and contrast-enhanced ultrasound
Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast medium to traditional medical sonography. Ultrasound contrast agents rely on the different ways in which sound waves are reflected from interfaces between substances. ...
(CEUS).
Renal ultrasonography
Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound.[Content initially copied from:]
(CC-BY 4.0)
/ref>
Technique
Advantages of ultrasound imaging of abdominal structures are that the procedure can be performed quickly, bed-side, involves no exposure to X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
s (which makes it useful in pregnant patients, for example) and is inexpensive compared to other often-used techniques such as computed tomography (CT scan) of the abdomen. Disadvantages are troublesome imaging if a lot of gas is present inside the bowels, if there is a lot of abdominal fat, and that the quality of the imaging depends on the experience of the person performing it.
The imaging occurs real-time and without sedation, so that the influence of movements can be assessed quickly. For example, by pressing the ultrasound probe against the gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
, a radiological Murphy's sign
In medicine, Murphy's sign (also known as Sweeney’s sign) is a maneuver during a physical examination as part of the abdominal examination. It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in chole ...
can be elicited.
Through the abdominal wall, organs inside the pelvis can be seen, such as the urinary bladder
The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine ente ...
or the ovaries
The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...
and uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
in women. Because water is an excellent conductor for ultrasound waves, visualizing these structures often requires a well-filled urinary bladder (this means the patients has to drink plenty of water before the examination).
Abdominal Ultrasound (Full Exam)
File:Abdominal Ultrasound Full Exam 43.jpg, Aorta
File:Abdominal Ultrasound Full Exam 44.jpg, Aorta
File:Abdominal Ultrasound Full Exam 45.jpg, Aorta
File:Abdominal Ultrasound Full Exam 46.jpg, Aorta
File:Abdominal Ultrasound Full Exam 47.jpg, Aorta
File:Abdominal Ultrasound Full Exam 27.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 28.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 29.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 30.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 31.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 32.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 33.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 34.jpg, Right kidney
File:Abdominal Ultrasound Full Exam 35.jpg, Left kidney
File:Abdominal Ultrasound Full Exam 36.jpg, Left kidney
File:Abdominal Ultrasound Full Exam 49.jpg, Left kidney
File:Abdominal Ultrasound Full Exam 50.jpg, Left kidney
File:Abdominal Ultrasound Full Exam 51.jpg, Left kidney
File:Abdominal Ultrasound Full Exam 52.jpg, Spleen
File:Abdominal Ultrasound Full Exam 53.jpg, Spleen
File:Abdominal Ultrasound Full Exam 54.jpg, Spleen
File:Abdominal Ultrasound Full Exam 55.jpg, Spleen
File:Abdominal Ultrasound Full Exam 37.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 38.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 39.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 40.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 41.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 42.jpg, Pancreas
File:Abdominal Ultrasound Full Exam 01.jpg, Liver
File:Abdominal Ultrasound Full Exam 02.jpg, Liver
File:Abdominal Ultrasound Full Exam 03.jpg, Liver
File:Abdominal Ultrasound Full Exam 04.jpg, Liver
File:Abdominal Ultrasound Full Exam 05.jpg, Liver
File:Abdominal Ultrasound Full Exam 06.jpg, Liver
File:Abdominal Ultrasound Full Exam 07.jpg, Liver
File:Abdominal Ultrasound Full Exam 08.jpg, Liver
File:Abdominal Ultrasound Full Exam 09.jpg, Liver
File:Abdominal Ultrasound Full Exam 14.jpg, Liver
File:Abdominal Ultrasound Full Exam 19.jpg, Liver
File:Abdominal Ultrasound Full Exam 20.jpg, Liver
File:Abdominal Ultrasound Full Exam 21.jpg, Liver
File:Abdominal Ultrasound Full Exam 22.jpg, Liver
File:Abdominal Ultrasound Full Exam 23.jpg, Liver
File:Abdominal Ultrasound Full Exam 24.jpg, Liver
File:Abdominal Ultrasound Full Exam 25.jpg, Liver
File:Abdominal Ultrasound Full Exam 26.jpg, Liver
File:Abdominal Ultrasound Full Exam 48.jpg, Liver
File:Abdominal Ultrasound Full Exam 10.jpg, Gallbladder
File:Abdominal Ultrasound Full Exam 11.jpg, Gallbladder
File:Abdominal Ultrasound Full Exam 12.jpg, Bile duct
File:Abdominal Ultrasound Full Exam 13.jpg, Bile duct
File:Abdominal Ultrasound Full Exam 15.jpg, Gallbladder
File:Abdominal Ultrasound Full Exam 16.jpg, Gallbladder
File:Abdominal Ultrasound Full Exam 17.jpg, Gallbladder
File:Abdominal Ultrasound Full Exam 18.jpg, Gallbladder
See also
* Contrast-enhanced ultrasound
Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast medium to traditional medical sonography. Ultrasound contrast agents rely on the different ways in which sound waves are reflected from interfaces between substances. ...
* Medical ultrasound
Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, mu ...
References
External links
Abdominal Ultrasound
information for patients from the American College of Radiology and the Radiological Society of North America
The Radiological Society of North America (RSNA) is a non-profit organization and an international society of radiologists, medical physicists and other medical imaging professionals representing 31 radiologic subspecialties from 145 countries a ...
.
Abdominal ultrasound
from MedlinePlus.
{{Digestive system procedures
Medical ultrasonography
Digestive system imaging