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An Ultrasound of the abdomen may be ordered by your physician to get a detailed look at the abdominal organs including the liver, gallbladder, pancreas, kidneys, and spleen, stomach, small intestine, and large intestine. Although the vascular system is not functionally related to the abdominal organs, the abdominal aorta passes through the abdomen and is considered a part of abdominal imaging.
The gallbladder is the only purely fluid-filled organ in the abdomen. Your clinician will frequently order an abdominal ultrasound to obtain more information on the solid organs of the abdomen including the liver, kidneys, pancreas, and spleen. Some abdominal organs are gas-filled like the stomach, small and large bowel and will not be seen well by this kind of imaging.
Ultrasound of the abdomen may help to evaluate findings your clinician has noted on your clinical examination such as a large abdominal aorta or an enlarged liver. Ultrasound is also the first line imaging scan for detecting a focal enlargement of the abdominal aorta called an aneurysm.
Ultrasound is also excellent for evaluating the liver and distinguishing fluid-filled findings such as liver cysts from other common benign (noncancerous) vascular lesions hemangiomas.
Your clinician may only want to evaluate a single functional system within the intraabdominal cavity. If you are having frequent urinary tract infections (UTIs) or pelvic floor problems, an ultrasound may be limited to the urogenital system. This is called a Renal or Kidney and bladder ultrasound. The imaging evaluates the kidneys for masses, calcifications, or ureter obstruction called hydronephrosis. The bladder is also evaluated so it needs to be full at the start of the study. Your technologist may scan you first with a filled bladder then ask you to empty your bladder and scan again. This quantitative evaluation of the bladder before and after emptying your bladder is called a Post Void Residual.
Ultrasound is the first medical diagnostic radiology imaging tool to evaluate the liver, kidney, or pancreas when laboratory tests are abnormal. If your liver function tests (LFTs) are abnormal, ultrasound can assess if the liver anatomically looks normal or whether it looks inflamed or contains masses. Liver function tests are very sensitive to alcohol use and medications since the liver’s primary function is to detoxify. The ultrasound imaging looks different for an enlarged inflamed liver called hepatitis versus a shrunken liver with long-standing liver disease like cirrhosis.
If a patient is jaundiced or laboratory enzymes are increased, ultrasound can be used to detect gallstones or pancreatitis. Both conditions can show similar symptoms or have similar abnormal laboratory results.
Most masses of the liver are benign. The most common liver mass is a vascular tangle called a hemangioma. The kidney may contain benign masses like angiomyolipomas or renal cell carcinoma (RCC). The pancreas may harbor small subtle masses which are difficult to detect clinically. Pancreatic masses may occur in the pancreatic head where the lesions may produce symptoms or in the tail which rarely produces symptoms until later on.
Ultrasound is also useful to detect calcifications (called stones) which can occur in the gallbladder, the kidneys, and the spleen. Calcification of the abdominal aorta can also be identified as a sign of atherosclerosis.
Ultrasound is a radiology imaging technology that uses sound waves to distinguish normal from abnormal tissues within organs. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected are presented as images for interpretation by a specialized radiologist to distinguish various findings. Because this radiology technology uses sound waves, it is also called a sonogram.
To look at the abdominal organs, the ultrasound technologist uses a handheld transducer (called a probe) to capture images by making air-free contact with your skin. To accomplish this, ultrasound gel resembling thin jello is applied to the skin and the transducer is placed over this area. Gentle pressure is applied while the technologist performs your imaging. This eliminates the air gap because ultrasound does not travel well through the air but does travel well through water-based solutions.
The ultrasound gel also allows the technologist to efficiently move across the entire abdomen to perform the scan and document the images of the study. The wand is gently curved so that the technologist can angle the probe into various angles. The abdomen is divided into four quadrants for the technologist: the right upper outer, right lower outer, left upper outer, and left lower outer quadrants. These quadrants are designated so that all organs in the intraabdominal cavity can be documented systematically.
Since ultrasound excels at evaluating fluid-filled organs, we want some organs distended such as the gallbladder. The gallbladder contracts when exposed to foods, especially fatty foods. So it is important to not eat 4-6 hours before the abdominal ultrasound to fully evaluate all the organs. Most people choose to schedule the imaging study first thing in the morning so that they can eat breakfast afterward. Avoid drinking coffee in the morning, unless you plan just a few sips without cream or sugar. If you need to take any medications in the morning, you can take these with water. Drinking water is fine, it will not interfere with the ultrasound study.
In this case, try to schedule the appointment first thing in the morning. You can drink plenty of water, but remember not to eat before your study.
At The Women’s Imaging Center, our technologists and physicians specialize in performing, detecting, and diagnosing abdominal ultrasound imaging and medical diagnostic conditions. We perform comprehensive imaging for women from head to toe and have decades of specialized training in all body organ systems and their relationships. For example, if we see a potential familial genetic trend in a patient with a family history of pancreatic and breast cancer, we may recommend genetic counseling. If we see multiple gallbladder polyps we may suggest following up more closely with your gastroenterologist.
We specialize in all these processes and work closely with other specialists such as gastroenterologists (GI specialists), genetic counselors, nephrologists (kidney specialists), or surgeons in a multi-disciplinary fashion.