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INTRODUCTION
PURPOSE
PROFESSIONALISM
CLINICAL SKILLS
EQUIPMENT
Select the proper transducer for the examination
The following conditions should be optimal:
Field size
Near gain
Far gain
Homogeneous technique from near to far field
Contrast
Well-defined borders
No areas of fade-outs
Low power setting with adjusted slope (TGC)
Overall interpretable images
CARE OF EQUIPMENT
A protective sheath may be used to cover a Transabdominal probe depending on skin
surface condition of the patient. At the end of the examination the sheath should be
disposed and probe cleaned in antimicrobial solution recommended by manufacturers.
STANDARDS SCANNING
FILM LABELLING
The following guidelines describe the examination to be performed for each organ and
anatomical region.
A complete exam include all organs
A limited exam would include one or more but not all of them.
LIVER SURVEY
The following should be imaged
o Long axis (coronal or sagittal)
o Transverse views
o Views comparing the echogenicity of the liver to the right kidney
o Major vessels (aorta/inferior vena cava) in the region of the liver
o Position of the IVC where it passes through the liver
o Regions of the ligamentum teres on the left
o Regions of the dome of the right lobe with right hemi diaphragm
o Right pleural space
o Main lobar fissure
o Visualization of hepatic veins in right and left lobes
o Right and left branches of the portal vein
o Intrahepatic bile ducts should be evaluated for possible dilatation.
o Measurements:
GALLBLADDER AND BILIARY TRACT
The gallbladder evaluation should include the following obtained in Supine position:
o Long axis (coronal or Sagittal)
o Transverse Views
o Left Lateral Decubitus ( left side down), erect or prone
o Intrahepatic ducts as described under the liver
o Size of extrahepatic ducts and intrahepatic ducts should be assessed
o Common Bile Duct in pancreatic head should visualized
PANCREAS
When possible the following should be identified in transverse and long axis projections :
o Pancreatic head
o Uncinate process
o Body
o Pancreatic tail
o Pancreatic duct
o Peripancreatic region assessed for adenopathy
SPLEEN
The following views should be performed:
o Either Sagittal or coronal
o Transverse and when possible
o Long axis (coronal or sagittal) projections
o Left pleural space
o Comparison echogenicity of upper pole of left kidney to that of the spleen
KIDNEYS
The views of each kidney should be obtained
o Long axis (coronal or sagittal)
o Visualization of the cortex and renal pelvis
o Transverse views which include upper pole, middle section at the renal pelvis, and
lower pole
o Comparison of renal echogenicity with adjacent Liver and spleen
o Perirenal regions for possible abnormality.