DR. UKACHUKWU I. H.
MBBS (IBADAN), FWACS (RADIOLOGY),
CERT. INTERV. RADIOLOGY (GERMANY)
OUTLINE
INTRODUCTION - PHYSICS AND KNOBOLOGY
ULTRASOUND ANATOMY
BASIC LIVER USS
BASIC SPLEEN USS
BASIC RENAL USS
BASIC PANCREAS USS
BASIC INTESTINAL USS
CONCLUSION
INTRODUCTION
SONAR – Sound Navigation &
Ranging
Range of frequencies in
diagnostic application is 2 – 20
MHz
B-Mode, M-Mode, Duplex,
B -Gain, TGC, Depth, Focus, Zoom
Invert, Reject/Supression,
SonoCT,
Artifacts – Reverbration, Mirror
Image, Shadowing, Enhancement,
Mirror Image
ULTRASOUND ANATOMY
Size
Shape
Echogenicity -Isoechoic, Hypoechoic, Hyperechoic
Echotexture -Coarse, homogenous, Heterogenous
Margins
Origin
Composition – Solid, cystic, Complex, Air,
BASIC LIVER SCAN
Normal liver parenchyma – hyerechoic to Kidney and
hypoechoic to normal pancreas & spleen.
Homogenous mid gray to mild echogenic parenchyma
Portal and Hepatic veins display anechoic tubular branching
structures . PV has bright echogenic walls.
Diaphragm, Ligament & Fissures of the liver appear highly
relective
Couinaud Segment
Fatty infiltration, Cirrhosis, Chronic Hepatitis,
Chronic RHF, AIDS, GSD, Gauchers, Wilsons
Hepatic Adenoma
Metastasis
- Hypoechoic
Lymphoma,
primary
malignancy
- Hyperechoic
Colonic ca, GIT Ca,
- Cystic : Ovarian, GI
sarcomas
HCC
Irregular hypoechoic
mass
Amebic abscess. Sagittal view shows a well-
defined, hypoechoic amebic abscess
containing diffuse internal echoes and
posterior acoustic enhancement.
Transverse view: two well-defined,
hypoechoic amebic abscesses containing
low-level internal echoes.
Gall Bladder
Long
Trans
GALL BLADDER
Cholelithiasis
Calcium / Cholesterol
stones
Acute
Cholecystitis
Cholecystitis thickened
wall >3mm
Dilated GB
Pericholestic fluid/edema
Sonographic Murphy’s sign
Increased Wall Color flow
Gall stones / Sludge
Emphysematous Cholecystitis
Elderly, DM,
1% of Cholecystitis
Vascular compromise of GB wall by Gas
forming organism-Clostridium spp., Ecoli,
Step., Staph.
Curvilinear echogenic areas in the Gall
bladder wall, the reverbration artefacts are
diagnostic
Obscuration of the gall bladder by high level
echoes
Biliary duct Obstruction
Dilated intrahepatic ducts
SPLEEN
Splenomegaly with siderotic nodules
RENAL SCAN
Nephrolithiasis
Renal Calculi
Renal Calculi +
Grade I
Hydronephrosis
Renal Cyst
Pancreas
INTESTINAL USS
Gross Ascites