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Ultrasound Services

A diagnostic ultrasound is a non-invasive imaging technique that sends high frequency sound waves into the body to produce images of soft tissues and internal organs.

WHAT IS AN ULTRASOUND?
Ultrasound enables the radiologist to make an accurate diagnosis of numerous medical conditions and diseases without the use of surgery or radiation by providing a clear window into the human body.

GENERAL INFORMATION
The ultrasound procedure involves passing a device called a transducer over the skin of the area to be examined. A series of images are produced and analyzed by an experienced radiologist.

Wake Radiology routinely utilizes state-of-the-art ultrasound equipment, which allows for the production of high-quality images for medical diagnosis over a wide range of anatomical areas and clinical indications, including abdominal, obstetrics and gynecology, vascular, musculoskeletal, and other soft tissues of the body.

Each location where ultrasound services are offered is accredited by the American College of Radiology. Our diagnostic medical sonographers are highly skilled professionals who have earned and who maintain their certification with the American Registry of Diagnostic Medical Sonographers.

SCHEDULING & REPORTS
Appointments are usually scheduled in advance. However, we will always try to accommodate patients in need of an urgent exam on the day it is requested.

Exam results are faxed to the referring physician within 24 hours of the study, or conveyed to your health care provider immediately, if requested, by telephone. Images and exam results are also readily available for viewing by your health care provider though access to our Wake Radiology PACS.

For patient preparation information, please see the appropriate exam type below.

ABDOMINAL EXAMINATIONS
Abdominal ultrasound examinations may be ordered for the patient with abdominal pain, abnormal laboratory tests, as follow-up to other types of imaging tests, for evaluation of the aorta for aneurysm, or a variety of other symptoms and indications. Color doppler imaging may also be used during an abdominal ultrasound exam to assess blood flow in the major blood vessels and to the various abdominal organs.

The complete abdominal ultrasound includes a thorough survey of the following abdominal organs and related structures:

• Liver
• Pancreas
• Gallbladder
• Aorta
• Kidneys
• Bile ducts
• Spleen

The right upper quadrant ultrasound may be ordered to target the following structures:

• Liver
• Pancreas
• Gallbladder
• Bile ducts
• Right kidney

The retroperitoneal ultrasound may be ordered to target the following structures:

• Kidneys
• Bladder
• Aorta and Inferior Vena Cava

Patient Preparation

• In order to allow for optimal visualization of the target organs, patients should go without food and drink for 8 hours prior to an abdominal study. Necessary medications may be taken with a small amount of water only. No chewing gum, please.
• An ultrasound to evaluate only the kidneys does not require an 8 hour fast.

OBSTETRICS & GYNECOLOGY

PELVIC ULTRASOUND
High resolution diagnostic ultrasound assists the physician in the evaluation of the uterus, ovaries, fallopian tubes and related anatomy. Color doppler imaging may be used during a pelvic ultrasound exam to assess blood flow in pelvic organs and structures.

Patient Preparation
Patients need to have a full urinary bladder before the pelvic ultrasound examination can be optimally performed. The patient should finish drinking 36 ounces of water one hour before her appointment time, and she should not empty her bladder from the time she begins drinking until the examination is complete.

OBSTETRICAL ULTRASOUND
Ultrasound may be performed during any stage of pregnancy. In early pregnancy, ultrasound is used to determine fetal age and viability. In the second and third trimesters, ultrasound is used to evaluate the fetus, monitor fetal growth and position, check amniotic fluid, survey the placental location, etc.

Patient Preparation

• First Trimester—Please follow preparation for pelvic exam as seen above
• Second and third trimester—No patient preparation is necessary
• Unknown dates—Please follow preparation for pelvic exam as seen above

ENDOVAGINAL ULTRASOUND
When conventional (i.e., transabdominal) scanning of the pelvis does not provide sufficient diagnostic information, your health care provider may request that an endovaginal ultrasound examination be performed immediately afterwards in order to more accurately assess the pelvic organs. However, on occasion, a dedicated endovaginal ultrasound examination may be all that is necessary. The endovaginal transducer usually allows for better visualization of the uterus/cervix, ovaries, and adjacent structures because it is only inches away from the organs that are being evaluated. The endovaginal transducer is commonly used in early pregnancy to detect fetal heart motion and to aid in the detection of ectopic pregnancies.

Patient Preparation
When requested as an endovaginal ultrasound only, a brief, conventional (i.e., transabdominal) pelvic ultrasound exam is usually performed immediately prior to this dedicated endovaginal exam to quickly survey the entire pelvis for unexpected findings that may not be visible on the endovaginal examination. Therefore, patients should follow the same prep outlined above for a conventional pelvic ultrasound exam.

VASCULAR COLOR DOPPLER PROCEDURES
High-resolution color doppler permits accurate noninvasive evaluation of a wide variety of blood vessels, but most commonly the carotid arteries in the neck and the veins of the lower extremities. Color doppler allows the medical sonographer to clearly document blood flow within vessels, providing a “window” of opportunity to make an accurate diagnosis faster. This color imaging capability combines a conventional black and white ultrasound image of internal structures with blood flow information derived from the Doppler effect superimposed upon it. 

Vascular procedures routinely performed at Wake Radiology include:

• Carotid Doppler
• Peripheral Venous Doppler of the lower extremities
• Peripheral Venous Doppler of the upper extremities
• Venous insufficiency Doppler
• Evaluation of Erectile Dysfunction

Patient Preparation
No patient preparation is necessary for routine vascular Doppler procedures
Length of study—approximately 1 1/2 hours.

Color Doppler ultrasound demonstrates a small area of plaque at the carotid bifurcation.

Color Doppler ultrasound of normal femoral vein at the level of the bifurcation of the deep and superficial femoral veins.

Other vascular ultrasound applications at Wake Radiology:

In addition to evaluating larger blood vessels, color Doppler evaluation of other structures (e.g., breast, testicle, thyroid, ovaries, etc.) significantly increases the diagnostic information available to the radiologist because it allows blood flow to be characterized in arteries and veins that are too small to visualize with the conventional ultrasound imaging alone.

Normal color Doppler ultrasound of the testicle demonstrates blood flow in the vessels.

SUPERFICIAL STRUCTURES/MUSCULOSKELETAL
The following superficial structures are grouped into the category of “small parts” exams. Color doppler is often used in small parts exams to assess blood flow.

Small Parts

• Breast: Ultrasound evaluation of the breast may be performed to resolve a specific question by mammography or to evaluate an abnormality detected by the patient or the patient’s health care provider on physical exam.
• Popliteal Fossa: An ultrasound exam of the posterior aspect of the knee may be performed to identify a Baker’s cyst or popliteal artery aneurysm.
• Scrotum: Ultrasound and color doppler ultrasound are commonly used in assessing a painful testicle, testicular mass, varicocele, or scrotal enlargement.
• Thyroid: An ultrasound exam of the thyroid may be requested for an enlarged thyroid gland, a thyroid mass, or laboratory tests indicating abnormal thyroid function.

Musculoskeletal 

• Shoulder: An ultrasound exam of the shoulder may be performed to assist in the diagnosis of a rotator cuff tear.
• Tendons: Tendons may be examined by ultrasound to determine the extent of tendon injuries.
• Pediatric Hips: An ultrasound exam may be performed to evaluate infant hips for dislocation. See pediatric ultrasound procedures.
• Soft Tissue: An ultrasound exam may be performed to identify a soft tissue mass or foreign body.

Miscellaneous

• Spinal Sonography: Screening for spinal cord abnormalities in newborn infants.
• Neonatal Echoencephalography: An ultrasound exam of the neonatal brain may be performed to identify neonatal hemorrhage, hydrocephalus, and other major structure abnormalities.

Patient Preparation
No patient preparation is required for scanning of superficial structures or musculoskeletal areas.

Ultrasound image of normal rotator cuff.

Ultrasound image demonstrates a torn rotator cuff.

Please bring all insurance information to each visit. Most major insurers will pay for radiology examinations, although some require prior authorization for certain procedures. Patients may be required to pay at the time of service depending on the type of insurance coverage. You should check your benefits with your insurers at least a day before the exam.

Your insurance policy is a contract between you and your insurance company. As a courtesy to you, we will be glad to file your insurance claims. Bring your insurance card with you when you come for the exam. You will be responsible for all services that are not covered by your insurance.

We participate with most health care plans. If you have any questions about your coverage, you may call our business office at (919) 787-8221 or toll free at 1-800-675-2232.