Ultrasound examination

Which organs can be examined using ultrasound?

In principle, ultrasound can be used to examine all organs, even an unborn baby. Exceptions are organs filled with air, such as the lungs and the gastrointestinal tract, as well as the bones, as in this case the ultrasound waves are completely "reflected" by the air and bones.

I am pregnant, can I still have an ultrasound scan?

Yes, of course. There is no risk to the baby from the ultrasound. The direct examination of the unborn child in the uterus also has no harmful effect.

What do I need to consider before an ultrasound scan?

Ultrasound upper abdomen:

We ask you not to eat for at least 6 hours before the examination, as otherwise the gallbladder will be empty and cannot be adequately assessed. If the gallbladder has been removed, the patient does not necessarily have to fast, but it is advisable to eat very little. We ask you to take your medication with a sip of non-carbonated water. Please do not drink coffee or smoke a cigarette, possibly tea, but this should be unsweetened. It is best to avoid flatulent foods the evening before.

Ultrasound lower abdomen:

We ask you to come with a full bladder (tap water or non-carbonated water), as an empty bladder cannot be assessed.

Carotid duplex sonography:

For men, a fresh shave optimizes the quality of the examination.

Please contact JUVENIS by phone at +43 1 236 3020by e-mail to empfang@juvenismed.at or via the contact formto make an appointment for a consultation or treatment.

What ultrasound examinations are available?

Ultrasonic surface

This refers to the skin and subcutaneous tissue. Changes such as "swelling" or "lump formation" often occur in a certain area of the body. These can grow slowly over a long period of time if they are benign, for example. Post-traumatic or after an accident of any kind, superficial changes can occur suddenly. There are also fast-growing changes on the surface, for example in malignant diseases.

In our everyday work, we typically diagnose benign neoplasms such as a lipoma (fatty tumor) or an atheroma (sebaceous gland).

In the case of post-traumatic swelling, ultrasound often reveals fluid accumulation in the form of hematomas (bruising) or diffuse edema (extensive swelling/fluid retention).

Malignant diseases can lead to skin or lymph node metastases from the primary tumor (metastases from the original malignant cells).

Ultrasound lymph node stations

We humans have around 600 lymph nodes which, together with the spleen and tonsils, belong to the secondary lymphatic organs and are distributed throughout the body as a lymphatic system. This system plays an important role in our immune system. The lymph nodes are distributed throughout the body, sometimes quite superficially. In the area above and below the collarbone, or in the armpits, as well as in the groin on both sides. 50% of our lymph nodes are located in the head and neck area.

Lymph nodes are easy to see with ultrasound. Their number, size and shape are examined and can often be used to differentiate between normal, inflammatory and enlarged or malignantly altered lymph nodes. Ultrasound examination of the lymph node sites is important in the surgical planning and aftercare of melanomas(skin cancer), as well as in the surgical planning of malignant diseases in the head and neck area, such as thyroid cancer. This examination is also common in the clarification of hematological diseases (for example of the hematopoietic bone marrow or the lymphatic system).

Ultrasound of the large vessels supplying the brain to the neck/carotid duplex sonography

For this examination, ultrasound/sonography and Doppler sonography are used, which together produce a cross-sectional image around the vessel and make the blood flow in the vessel visible and measurable. The common carotid artery, the internal carotid artery, the external carotid artery and the vertebral artery can be examined on the left and right.

In various diseases, the arterial vessels (which supply the body's cells with oxygen and nutrients, among other things) can change and this can lead to stenoses (constrictions) caused by plaque deposits and calcifications which, the more they progress, can have dangerous consequences for the patient, for example with an increased risk of stroke. For example, untreated high blood pressure, untreated high blood lipids, lipometabolic disorders, diabetes, etc. Smoking/nicotine abuse can also pathologically alter/constrict the arterial vessels.

Doppler ultrasound makes it possible to detect whether there are pathological plaques (deposits) in the vessels and the extent to which the lumen (diameter) of the vessel is impaired or narrowed.

In the course of this examination, the intima-media thickness (thickness of the inner lining of the vessel) is measured, which is an important indicator of fat and calcium deposits in other arteries (for example in the heart - coronary heart disease [CHD] or in the legs - intermittent claudication [PAOD]). This examination is necessary in the course of some surgical preparations/operation approvals. Furthermore, aneurysms (pathological dilation of the arteries) can be diagnosed, which in some cases need to be checked regularly and in some cases surgically repaired.

Ultrasound of the deep leg veins / venous duplex sonography

This examination is primarily used to rule out or detect and assess the extent of deep vein thrombosis, or DVT for short (blood clots in the deep veins of the legs). It can also diagnose thrombophlebitis (inflammation and clots in the superficial veins) or venous insufficiency in varicosity (leaking venous valves due to varicose veins) or post-thrombotic syndrome (after a thrombosis has occurred), which often leads to leg oedema (swollen legs/feet).

Ultrasound of the thyroid gland

The ultrasound of the thyroid gland involves measuring the size of the organ, the position of the organ, the shape and the nature of the tissue. It plays an important role in the assessment of any cysts and nodules, which can be detected from a size of just a few millimetres. There are numerous characteristics in ultrasound that make it possible to classify changes in the thyroid tissue and to initiate any further clarification that may be necessary (for example by means of blood analysis, nuclear medicine or biopsy/sampling).

There are some clinical pictures that show typical images on ultrasound. For example, autoimmune thyroid disease - Hashimoto's disease. Thyroid ultrasound is also used as part of a follow-up or post-operative check-up.

Ultrasound of the neck organs/neck soft tissues

In this examination, the parotid gland and submandibular gland (large salivary glands) are examined on both sides. Their size and condition are assessed. There are chronic inflammatory changes, some of which are caused by autoimmune diseases. Then there are concretions (salivary stones) that cause ductal edema (obstruction of an excretory duct, ductal dilatation, accumulation of saliva and swelling) and can be very painful. There are benign and malignant changes within these glands, and here too the ultrasound features are used to identify the need for further clarification.

Ultrasound abdominal wall and groin

The most common examples are hernia inguinalis (inguinal hernia) or hernia epigastrica (abdominal wall hernia/upper abdominal hernia) or hernia cicatricea (incisional hernia). This involves a weakness and consecutive gap in the abdominal wall/scar, whereby subcutaneous fatty tissue, peritoneum and intestines can protrude through the gap.

Ultrasound upper abdomen

The liver, gallbladder, pancreas (pancreas) and spleen are located in the upper abdomen, along with lymph nodes and the large blood vessels, the abdominal aorta (abdominal artery) and inferior vena cava (inferior vena cava).

For example, it is possible to determine whether the organs are within the normal range in terms of size and structure, or whether changes are present as part of various clinical pictures. For example, splenomegaly (enlargement of the spleen) in the case of an Ebstein-Barr virus (EBV) infection.

Ultrasound kidneys

The kidneys are located retroperitoneally (behind the peritoneal cavity/behind the peritoneum). It is examined whether the kidneys are in a normal position, of normal shape and size, whether there is hydronephrosis (urinary retention) or other abnormalities.

Ultrasound kidney transplant (NTX)

If the kidneys on both sides no longer function due to advanced kidney disease, a kidney is often transplanted. The transplanted kidney is then regularly examined using blood analysis/renal function parameters and ultrasound.

Ultrasound Residual urine

In this examination, the urine volume in the bladder is measured post-micturition (immediately after urination). This should always be less than 100 ml.

Ultrasound lower abdomen

The urinary bladder and lower abdominal organs (uterus/uterus, ovaries and prostate) are examined for abnormalities.

Diseases of the appendix (appendix) such as appendicitis (inflammation of the appendix) can also be diagnosed. If the inflamed appendix itself cannot be seen, it can be diagnosed on the basis of the clinical findings (typical pain, fever, nausea and vomiting) and features on ultrasound, such as ascites/free fluid and/or lymphadenopathy, and further surgical clarification can be initiated promptly.

Ultrasound muscles and joints (shoulder, elbow, wrist, hip, knee, ankle, palm, sole of the foot, Achilles tendon, etc.)

The musculoskeletal system consists of muscles, tendons and joints. Ultrasound can be used to diagnose tendinitis (tendon inflammation), or partial/total rupture (tendon tear/tear), muscle fiber tear, joint effusion (pathologically increased fluid accumulation in a joint), hematoma (bruise), ganglion (benign circumscribed change filled with gel-like fluid)/Baker's cyst (fluid-filled cyst typically in the medial popliteal fossa) and bursitis (inflammation of the bursa). It is also possible to detect intramuscular (within the muscle) space-occupying lesions (both benign and malignant) or muscle atrophy ("atrophy" of the muscle).

Breast ultrasound incl. axilla bds.

The first thing to mention here is that an ultrasound examination alone is not suitable for the early detection of breast cancer. From the age of 40, women in Austria are invited to have a mammogram every other year as part of the early detection of breast cancer (BKF) and, depending on the density of the mammary gland, to have a supplementary ultrasound scan of both breasts.

Breast ultrasound can be performed at any age, even if there are questionable changes at a young age. It can also be used regularly and often without hesitation, for example to check the progression of benign changes.

Men should also have any changes such as swelling, lumps, increase in size, etc. checked. For example, men can develop mammary gland tissue due to changes in their hormone balance. This tissue is usually found retromammillary (immediately behind the nipple) and can feel like a lump and be painful. If a man has gynecomastia vera (breast gland tissue is present), it is important to remember that these cells could also develop into breast carcinoma (breast cancer).

There are benign changes such as cysts and fibroadenomas as well as normal lymph nodes within the breast. Breastfeeding women may develop mastitis (inflammation of the mammary glands). After a trauma/accident, hematoma formation (bruising) can occur in the breast.

Ultrasound testicles:

Ultrasound is used to examine the morphology ("shape") and vascularization (blood flow) of the testicles, epididymis and spermatic cords. Tumors, inflammations, benign changes such as calcifications and cysts can be detected. Furthermore, hydrocele or varicocele (accumulation of fluid in the scrotum due to varicose veins, for example).

In boys, the testes (testicles) in the scrotum (scrotum) may not be palpable after birth - cryptorchidism (undescended testicles) can also be examined sonographically. The testicles are usually located on one or both sides in the inguinal canal or abdominal cavity. As a rule, spontaneous postnatal descensus (spontaneous "sinking" of the testicles into the scrotum) occurs in the first 6 months of life.

Please contact JUVENIS by phone at +43 1 236 3020by e-mail to empfang@juvenismed.at or via the contact formto make an appointment for a consultation or treatment.

Responsible for the content of this page: Dr. Negar Fakhrai