Ultrasound imaging
Ultrasound, or sonography, uses very high frequency, low power sound waves to make an image of fluid and organs within the body. Ultrasound images are obtained using a transducer (the camera of ultrasound). Ultrasound does not use ionizing radiation (like X-rays) and has been shown to be safe and cost-effective for patients of all ages.
Because of the way images are taken, ultrasound is highly operator-dependent. Salem Health only employs diagnostic medical sonographers registered through an independent, national licensing body — the American Registry of Diagnostic Medical Sonographers (ARDMS).
In general, ultrasound creates images of soft tissues and organs, as well as provides guidance for invasive procedures such as biopsies and fluid drainages.
Abdomen
Why would my physician order this procedure?
To evaluate the aorta, inferior vena cava, liver, gallbladder and bile ducts, pancreas, kidneys and spleen. Some reasons providers order an abdominal ultrasound are for unexplained abdominal pain, hepatitis, nausea, vomiting, jaundice and gallstones.
Exam preparation
Do not to eat or drink for eight hours before your exam. Fatty foods can contract your gallbladder and result in false readings and food in your stomach can interfere with the ultrasound beam. It is okay to take your medications with water if needed.
If you are diabetic, please consult with your physician.
What to expect
You will lie on your back while the sonographer takes images with the ultrasound transducer and a warm gel.
The sonographer will sometimes press firmly to obtain appropriate images and will have you hold a deep breath while they take images.
Often the sonographer will take additional images while you lie on your right and/or left side.
Your sonographer will not give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your doctor in one to two business days.
How long will it take?
In general, abdominal ultrasounds take about 30 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Appendix
Why would my physician order this procedure?
Physicians usually order appendix ultrasounds in cases where appendicitis is suspected.
Exam preparation
No prep is needed to evaluate the appendix.
What to expect
You will lie on your back while the sonographer takes images by pressing with the ultrasound transducer and warm gel. Often the sonographer will take additional images while you lie on your left side.
Your sonographer will not give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your doctor in one to two business days.
How long will it take?
Ultrasounds of the appendix generally take between 15 and 30 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Biopsies
Overview
There are many organs and tissues that can be biopsied under ultrasound, including the thyroid, liver, kidneys and lymph nodes under the skin. Ultrasound is used to view the area to be biopsied and confirm the biopsy needle is placed appropriately. Ultrasound is preferred because no ionizing radiation is used, and because the needle can be visualized in real-time.
Exam preparation
Each biopsy has specific preparation requirements. The scheduling department or your physician’s office will instruct you regarding exam prep. If you are on any anti-coagulants or ‘blood-thinners’ talk to your physician about whether you should stop the medicine before the procedure.
What to expect
Each biopsy is different. Before the procedure the nurse and the sonographer will completely explain your specific biopsy, possible complications and what to expect. The radiologist will numb the area to be biopsied. The numbing medication will burn and sting, but this only lasts a short time. The radiologist then uses a small biopsy needle through the numbed area to take a tissue sample.
Biopsies of deeper areas like the liver or kidneys are more involved. The radiologist will usually have the nurse administer a sedative and pain medication. The medications will make you sleepy and relaxed, but you will still be awake so we can speak with you during the procedure.
How long will it take?
Ask the scheduler or your doctor’s office for specific details, but generally plan to be at the hospital for anywhere from one to four hours. Each biopsy can vary, but generally from the time you are numbed up until the doctor is finished is only 15 minutes. The remainder of the time is for the nurses to review your health history and medications, prepare you for the biopsy, and to monitor you after the procedure.
Possible complications or side effects
Your nurse and the radiologist will thoroughly review the possible complications for your specific biopsy before the procedure begins.
Obstetrical (fetal, first trimester)
Overview
Ultrasounds in the first trimester of pregnancy are commonly ordered if the provider wishes to confirm the baby’s gestational age or if the mother has pain or bleeding.
Exam preparation
We ask you to drink 20 ounces of water 30 minutes before the exam to ensure you have a full bladder.
What to expect
You will lie on your back on ultrasound bed. The sonographer will scan through the pelvis with the ultrasound transducer and warm gel. Depending on how far along the pregnancy is, or when additional detail is needed, a special ultrasound probe is used to image the fetus through the vaginal cavity. This procedure is similar to a pelvic exam at your gynecologist.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two business days.
How long will it take?
Ultrasounds in the first trimester generally take less than 30 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Obstetric (fetal, second and third trimesters)
Overview
Most ultrasounds in the second trimester are the “20-week scans” or anatomy screens. These are routinely ordered on all pregnancies to confirm the gestational age of the fetus and to evaluate fetal anatomy. Additional, similar exams are sometimes ordered by the provider to evaluate fetal growth later in the pregnancy, follow up a previous finding or to check fetal well-being and amniotic fluid. Most people are familiar with this ultrasound because this is when it is possible to determine the baby’s sex.
Exam preparation
The scheduling department will give you specific exam preparation instructions, but generally we recommend drinking 20 ounces of water 30 minutes before the exam to ensure you have a full bladder.
What to expect
The routine 20-week anatomy scans are one of the most in-depth exams that we perform at Salem Hospital. Many images of fetal anatomy including multiple growth measurements are taken for the radiologist to evaluate. The sonographer will scan through the pelvis with the ultrasound transducer and warm gel. Often additional pictures are taken with you on your left and/or right side.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two business days.
How long will it take?
Because this is one of the most involved studies that we perform, they can last anywhere from 45 to 90 minutes. Follow-up ultrasounds later in the pregnancy are often quicker.
Possible complications or side effects
No complications are expected from the ultrasound.
Paracentesis
Overview
Certain conditions or recent surgeries can cause fluid to build up in the abdomen called ascites. When it becomes necessary to drain the fluid, the radiologist can perform a paracentesis.
Exam preparation
If you are on any anti-coagulants speak to your provider about whether you should hold the medicine before the procedure.
What to expect
You will lie on your back on a bed while the sonographer uses ultrasound to find a safe place on your abdomen to access the fluid. The radiologist and nurse will discuss the procedure and its complications before they begin. The radiologist will numb the area with a local anesthetic. After you are numb, the doctor advances a small needle catheter just far enough to access the abdominal fluid. Often, a sample is taken to the lab for analysis at your provider’s request. Once the fluid is drained the catheter is removed and the nurse will evaluate you before you leave.
How long will it take?
Expect to be at the hospital for 60 to 90 minutes. The actual drainage portion varies greatly — 30 to 60 minutes is typical.
Possible complications or side effects
If a large volume of fluid is drained you may feel weak or lightheaded immediately after the procedure. Please discuss any concerns you have with the nurse or radiologist. The nurse will review potential complications and warning signs before you leave the department.
Pelvis
Overview
Pelvic ultrasounds evaluate the uterus, ovaries and the adjacent pelvic space for abnormalities. In some cases Doppler ultrasound is used to confirm the presence of blood flow in the ovaries.
Exam preparation
We ask that you drink 20 ounces of water 30 minutes before the exam to ensure you have a full bladder.
What to expect
You will lie on your back on the ultrasound bed. The sonographer will scan through the pelvis with the ultrasound transducer and warm gel. When additional detail is needed (on adults only), a special ultrasound probe is used to scan the pelvis through the vaginal cavity. This is similar to a pelvic exam at your gynecologist.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two business days.
How long will it take?
Ultrasounds of the pelvis generally take about 30 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Renal (kidney)
Overview
Providers commonly order a renal ultrasound to evaluate the kidneys when there is renal failure or if there is pain in your side. The exam includes images of the bladder, and physicians often order a renal ultrasound when they wish to evaluate the bladder.
Exam preparation
We ask that you drink 20 ounces of water 30 minutes before the exam to ensure you have a full bladder.
What to expect
You will lie on your back and/or your side while the sonographer takes images with the ultrasound transducer and warm gel. The sonographer will sometimes press firmly to obtain appropriate images and will have your hold a deep breath while they take images.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two business days.
How long will it take?
Renal ultrasounds generally take less than 20 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Scrotum
Overview
Ultrasound is an excellent way to evaluate any organ or soft tissue, especially tissue that is close to the surface. Ultrasound is especially ideal to image the scrotum because there is no ionizing radiation like X-rays, high resolution, and ability to evaluate for proper blood flow.
Exam preparation
No special preparation is needed.
What to expect
You will lie on you back on the ultrasound bed while the sonographer uses a transducer and warm gel to take around 15 images of each testicle and the surrounding tissue. Doppler ultrasound is used to evaluate the blood flow, so you may hear a noise that sounds like a heartbeat as the measurement is taken.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two business days.
How long will it take?
Scrotal ultrasounds are generally less than 20 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Thoracentesis
Overview
Certain conditions or recent surgeries can cause fluid to build up in the chest cavity between the lung and the chest wall, called a pleural effusion. When the effusion is large enough or is clinically significant it can be drained by a radiologist in a procedure called a thoracentesis. The procedure is performed in the ultrasound department because ultrasound is used to find the best site to access the fluid.
Exam preparation
If you are on any anticoagulants (blood thinners), talk to your physician about whether you should hold the medicine before the procedure.
What to expect
You will sit on a bed with your arms resting on a table at shoulder height. The sonographer will use the ultrasound transducer to scan on your back to find the fluid around your lung.
The radiologist and the nurse will explain the procedure and possible complications before beginning. The doctor will then numb a spot on your back. The radiologist then uses a small needle catheter to go through the skin just far enough to access the fluid. Often a fluid sample is taken to the lab for analysis. The catheter is left in while the fluid drains, then is removed and a bandage placed at the site. The nurse will evaluate you before you leave.
You can expect to feel the need to cough during the procedure, and will sometimes feel chest pressure. Be sure to keep your nurse informed of any symptoms you are having during the procedure so he or she can monitor you.
How long will it take?
Expect to be at the hospital for 60 to 90 minutes. The actual drainage portion takes around 10 to 15 minutes.
Possible complications or side effects
Any time a needle is placed there is a risk of bleeding or infection. Additionally with a thoracentesis there is a risk of puncturing the lung. This is a rare complication and the nurse and the radiologist are highly experienced and trained to deal with this possibility. The nurse will review potential complications and warning signs before you leave the department.
Thyroid
Overview
The thyroid is an important metabolic organ in the neck. Physicians often order an ultrasound when the thyroid is enlarged or if certain thyroid blood tests are abnormal. Thyroid ultrasounds also evaluate for the presence of thyroid nodules.
Exam preparation
Because the thyroid gland is low on the neck, wear a low-collared or button-up shirt that can easily expose the neck to the collar bone.
What to expect
You will lie on your back on the ultrasound bed with a pillow under your neck. This will help straighten your neck and make it easier to image. The sonographer takes images with the ultrasound transducer and warm gel.
Ultrasound is very technical and the sonographers are highly trained, but they are not qualified to give you results or make a diagnosis. The interpretation is the responsibility of the radiologist, who will send a report to your provider in one to two days.
How long will it take?
A complete examination or follow-up of the thyroid can take anywhere from 15 to 30 minutes.
Possible complications or side effects
No complications are expected from the ultrasound.
Where is this procedure done?
Ultrasounds are available at the following Salem Health locations: