By Jane Alty, Edward Hoey, Stephen Wolstenhulme, Michael Weston, Jane Aly
""The authors are to be congratulated for his or her efforts. ... not just are you close to gaining knowledge of a superb global of non-invasive imaging, but additionally your pathway to attaining the competence that you simply hope might be made significantly more straightforward through this book.""-Henry C. Irving FRCR, advisor Radiologist, St James's college clinic, Leeds, united kingdom; Ex-Treasurer of The Royal collage of Radiologists""The authors Read more...
summary: ""The authors are to be congratulated for his or her efforts. ... not just are you on the point of learning a superb international of non-invasive imaging, but in addition your pathway to reaching the competence that you just wish could be made significantly more uncomplicated by means of this book.""-Henry C. Irving FRCR, advisor Radiologist, St James's college medical institution, Leeds, united kingdom; Ex-Treasurer of The Royal university of Radiologists""The authors then stroll you lightly during the very important steps fascinated by each one test, guiding the way in which with priceless diagrams indicating probe positions and corresponding anticipated perspectives of the underlying
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Additional info for Practical Ultrasound : An Illustrated Guide, Second Edition
Example text
Take note of the liver characteristics listed in Step 4. Look for the portal vein and follow its course into the liver. The porta hepatis is the region where the vein enters the liver. At this point, look for the CBD by rotating the probe slightly anticlockwise and looking anterior to the portal vein. The hepatic artery runs between the duct and the portal vein (usually). To help locate the CBD: −− turn on colour: no flow in CBD; remember to have a Doppler angle <60o −− increase line density by reducing sector angle and depth −− use zoom to magnify the area Follow the course of the CBD, looking for any calculi or obstruction.
Indb 13 13/05/2013 13:36 14 Practical Ultrasound: An Illustrated Guide Probe position Instructions 4 Midline – TS: left lobe of liver ●● ●● ●● ●● Keep the probe TS and in the midline. Scan through the whole of the left lobe of the liver by angling the probe cranially then caudally. Take note of: −− the echogenicity: diffuse and focal −− the size −− the surface: is it smooth or nodular, is it cirrhotic? −− the bile ducts: are they dilated? −− any lesions: do they have mass effect? −− hepatic and portal veins If there is difficulty in viewing the liver clearly, ask the patient to take a deep breath in to push the liver down.
4 The aorta bifurcates just inferior to this level at L3/4. indb 8 T12 IVC L1 L2 L3 Caudate lobe 13/05/2013 13:36 3 Abdomen 9 LS: left of midline Probe position Diaphragm Lungs Stomach Loops of bowel Liver Heart IMA T11 T12 L1 LRV Coeliac SMA axis Aorta Bifurcation of aorta L4 L2 L3 PERITONEAL SPACES TS Probe position: L1 Left subphrenic space Falciform ligament Right subphrenic space Liver Pancreas Hepatorenal space (Morrison’s pouch) Right kidney Spleen Ao IVC L1 Lesser sac Left kidney LS Probe position: right MCL Bare area of liver Hepatorenal space (Morrison’s pouch) Lungs Subphrenic space Liver Subhepatic space Right kidney Loops of bowel ●● Key Recto-uterine pouch (pouch of Douglas) points 1 The spaces are formed between folds of peritoneum.