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Brief overview of Sonography

 

The ultrasound department is an integral part of a radiology service. As the simplest, cheapest and least invasive form of cross sectional imaging, it is the first line examination in many conditions.

 

The main limitations of ultrasound are that it does not pass effectively through bone or air, and the quality of the image deteriorates with depth. Despite this, ultrasound can effectively image all the solid organs of the abdomen and pelvis, as well as the neck breast and testes.

 

These organ systems make up the vast majority of ultrasound examinations within the average radiology department. Scanning of the foetus is normally carried out in dedicated maternity departments, while vascular and cardiac scanning are also generally carried out within their own specialties.

 

Improvement in resolution due to the development of high frequency scanners has lead to dramatic increase in the amount of musculoskeletal sonography, however this is still a small specialty in the UK.

 

High frequency probes have also made scanning of the bowel feasible, though this is technically difficult, and only rivals the sensitivity and specificity of computed tomography (CT) in centres with a particular interest and expertise.

 

The air filled lung fields are often considered a bar to the use of ultrasound, however consolidated or collapsed lungs are well seen with ultrasound in the presence of an effusion

 

The neonatal brain is often examined with ultrasound, before ossification is complete, and even the adult brain can be examined using specialised low frequency probes through a thin section of cortex just anterior to the ear.

 

Within paediatrics, ultrasound is especially useful. The real time image does not require a static subject in contrast to CT, magnetic resonance imaging (MRI) or x-ray, so an anaesthetic is not generally required. The absence of ionising radiation also makes it particularly attractive to the clinician.

 

Sonographers

 

Diagnostic ultrasound is generally performed by practitioners with a specific education. Within a radiology department radiologists and sonographers perform the vast majority of scans.

 

Radiologists do their ultrasound training as part of their 5 year registrarship. Sonographers working within radiology departments are normally, but not exclusively radiographers who have undertaken a 2 year postrgraduate training course. This was traditionally called the diploma in medical ultrasound (DMU), but is now known as the postgraduate diploma in clinical ultrasound.

Within maternity many of the sonographers are midwives rather than radiographers, while cardiology and vascular medicine have their own specialists . In all of the above specialties, some of the medical practitioners also routinely perform ultrasound scans.

 

For more information on Sonographer training visit the BMUS website