Ultrasonography (USG) is a scanning procedure that uses high-frequency sound wave technology. The purpose of ultrasound is to produce images of the internal organs of the body. Ultrasound is used for a variety of purposes, from examining the condition of the fetus, detecting disease, to assisting doctors in surgery or taking tissue samples (biopsy).
Unlike other scanning procedures, such as X-rays (X-rays) and CT scans that use radiation, ultrasound uses sound wave technology to produce images of internal organs. Therefore, this action is considered safe, including for pregnant women.
There are 3 types of ultrasound that are generally used, namely:
- External ultrasound. This type of ultrasound is done by moving the scanner (probe) on the surface of the patient's skin.
- Internal ultrasound. Internal ultrasound is performed by inserting a probe into the patient's vagina or anus.
- Endoscopic ultrasound. Endoscopic ultrasound is performed by inserting a probe that has been attached to the endoscope through the esophagus. The endoscope is a thin, flexible tube, which has a camera and a light at the end.
Ultrasound Indications
Based on its intended use, ultrasound is divided into two categories, namely pregnancy ultrasound and diagnostic ultrasound. Here is the explanation:
1. Pregnancy Ultrasound
The purpose of doing a pregnancy ultrasound, among others, to:
- Confirming pregnancy, whether single or multiple pregnancies.
- Knowing the gestational age and estimating the time of delivery.
- Monitor the development of the fetus and find out its gender.
- Check the fetal heart rate, blood flow, and oxygen levels.
- Check the condition of the uterus, cervix, ovaries, and placenta.
- Detects birth defects in the fetus, such as Down's syndrome.
- Knowing the position of the fetus (normal, transverse, or breech).
- Checking amniotic fluid levels and assisting in the process of taking amniotic fluid samples (amniocentesis) if needed.
- Detects pregnancy outside the uterus (ectopic pregnancy), tumors, and confirms if a miscarriage occurs.
2. Diagnostic Ultrasound
Diagnostic ultrasound is used to detect a number of diseases, depending on the part of the body being examined. The following is the use of diagnostic ultrasound on a number of body organs:
- head ultrasound
Ultrasound of the head is generally done to detect brain abnormalities in babies which can be caused by premature birth, brain injury or bleeding, birth abnormalities such as hydrocephalus, infection, tumor, or brain nerve disorders. In adults, ultrasound of the head is used to detect the location of the tumor during head surgery procedures.
- neck ultrasound
Ultrasound of the neck is done to check the condition of the organs in the neck, such as the thyroid gland, salivary glands, and blood vessels in the neck. Ultrasound of the neck also aims to detect lumps, collections of pus (abscesses), infections, cysts, and tumors in the neck. Doctors can also use a neck ultrasound to help take a tissue sample (biopsy) in the neck.
- mammary ultrasound
Mammary ultrasound or breast ultrasound aims to detect the size and location of the lump in the breast, as well as find out whether the lump is a fluid-filled cyst or a solid lump. Breast ultrasound is also used as a guiding procedure in the process of taking tissue samples (biopsy) on lumps in the breast.
- abdominal ultrasound
Abdominal ultrasound is used to examine the condition of the liver, kidneys, spleen, bile, and pancreas. Some diseases that can be detected through abdominal ultrasound are enlarged spleen, appendicitis, pancreatitis, liver cancer, kidney stones, bladder stones, and hernias.
Abdominal ultrasound is also used to see blood flow in the abdomen, as well as as a guide when performing tissue sampling (biopsy) on internal organs of the abdomen or when removing pus from the abdominal cavity.
- Pelvic ultrasound
Pelvic ultrasound is done to detect abnormalities or diseases in the uterus, cervix, ovaries, fallopian tubes, vagina, and bladder. Pelvic ultrasound can detect conditions, such as fibroids, uterine tumors or cancer, pelvic inflammation, prostate disorders, and infertility. In addition to detecting these disorders, pelvic ultrasound is also used to determine the location of spiral contraception and help doctors take eggs in IVF procedures.
- Testicular ultrasound
Ultrasound of the testicles or testicles aims to detect pain, swelling, or abnormalities in the testicles, which can be caused by trauma, spermatocele, tumor, varicocele, twisted testicle (testicular torsion), and undescended testicle (cryptorchismus).
- Transvaginal ultrasound
Just like pelvic ultrasound, transvaginal ultrasound aims to see the condition of the female reproductive organs. The difference, transvaginal ultrasound is done by inserting a scanner through the vagina. The images produced on transvaginal ultrasound are also clearer than on pelvic ultrasound.
Transvaginal ultrasound is used to detect abnormalities in the uterus that can cause pelvic pain, vaginal bleeding, and infertility. Transvaginal ultrasound can also see the growth of cysts and other abnormal tissue in the uterus, such as fibroids. In pregnant women, transvaginal ultrasound can be done to monitor the fetal heart rate, as well as see abnormalities in the cervix that can cause premature birth or miscarriage.
- Transrectal ultrasound
Transrectal ultrasound aims to detect abnormalities or diseases in the anus and rectum, such as tumors or anal cancer. Transrectal ultrasound can also be done to check the condition of the reproductive organs in female patients who cannot undergo transvaginal ultrasound. In male patients, transrectal ultrasound can be used to examine the condition of the prostate gland, as well as detect and determine the size of prostate cancer.
Ultrasound Warning
There are several things to know before undergoing an ultrasound procedure, namely:
- Ultrasound of the head can not be done in children who have closed the crown (aged over 6 months).
- Ultrasound of the head in adult patients can only be done at the time of head surgery procedure, when the patient's skull has been exposed.
- Excess stomach acid, obesity, and food residue in the stomach and intestines can affect the results of an abdominal ultrasound.
- Applying powder or lotion to the breast before undergoing mammary ultrasound can affect the results.
- Be sure to tell your doctor about any medications, supplements, or herbs you are taking.
Before ultrasound
The preparation that must be done before the ultrasound depends on the type of ultrasound that will be carried out. Some of these preparations are:
- Fasting 8-12 hours before undergoing abdominal ultrasound, so that the organs in the stomach are clearly visible
- Consume 2-3 glasses of water one hour before the pelvic ultrasound and do not urinate until the procedure is complete
- Empty the bladder first for patients who will undergo transvaginal ultrasound
- Wearing special clothes and removing jewelry to facilitate the ultrasound process
On abdominal ultrasound and pelvic ultrasound, the patient may be given an injection of contrast fluid. This fluid serves to provide a clearer picture of the body's organs.
Ultrasound Procedure
The ultrasound procedure generally lasts 15–45 minutes. The stages depend on the type of ultrasound performed, as described below:
1. External ultrasound
The stages of external ultrasound are as follows:
- The patient will be asked to lie down in bed.
- The doctor will apply a lubricating gel on the part of the body to be examined to facilitate the movement of the scanner or transducer. The patient will feel a cooling sensation when the gel is applied.
- The transducer will send sound waves to the organ being examined. These sound waves will be reflected back and displayed in the form of an image on the monitor.
- The patient may be asked to change position, so that the doctor can more easily reach the organ to be examined.
- During the ultrasound, pain or discomfort may appear when the body part is pressed. Tell your doctor if the pain gets worse or is very bothersome.
2. Internal ultrasound
Internal ultrasound is carried out through the following stages:
- The patient will be asked to lie down with the pelvis slightly elevated.
- In a transvaginal ultrasound, the doctor will insert a probe that has been coated with a gel and a sterile barrier through the vagina. While on transrectal ultrasound, the probe is inserted through the anus.
- The function of the probe is the same as the transducer, which is to send sound waves to the organs being examined. The wave will be reflected back and displayed in the form of an image on the monitor.
- The patient may feel uncomfortable during the examination.
3. Endoscopic ultrasound
In endoscopic ultrasound, the patient will initially be given a sedative or local anesthetic to reduce discomfort or pain during the procedure. Then, the patient will be asked to lie on his side.
The doctor will insert the endoscope through the patient's mouth and push it down the esophagus to the part of the organ to be examined. Just like other types of ultrasound, the image will be captured through sound waves and will be visible on the monitor screen.
After Ultrasonography
After the ultrasound is complete, the doctor will remove the gel on the patient's skin, and the patient can get back to dressing. Patients who were asked to hold their urine during the examination were also allowed to urinate. Patients are usually allowed to go home and carry on with their normal activities after the ultrasound.
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