Ultrasound examination

Which organs can be examined using ultrasound?

Ultrasound can basically be used to examine all organs, even an unborn baby. Exceptions are air-filled organs such as the lungs and the gastrointestinal tract, as well as bones, because in these cases the ultrasound waves are completely "reflected" by air and bone.

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

Yes, of course. Ultrasound poses no risk to the baby. Even the direct examination of the unborn child in the uterus has no harmful effect.

What do I need to consider before an ultrasound examination?

Upper abdominal ultrasound:

We ask you not to consume any food 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 remain fasting, but it is advisable to eat only a little. We ask you to take your medication with a sip of non-carbonated water. Please do not drink coffee, do not smoke cigarettes; tea is possible, but it should be unsweetened. It is optimal to avoid flatulent foods the evening before.

Lower abdominal ultrasound:

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 3020, by e-mail at empfang@juvenismed.at or via the contact form, to arrange a consultation or treatment appointment.

Which ultrasound examinations are available?

Surface ultrasound

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

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

In the case of post-traumatic swellings, fluid accumulations often appear in the ultrasound in the context of hematomas (bruises) or diffuse edema (surface swelling/fluid retention).

In the case of malignant diseases, skin or lymph node metastases can occur originating from the primary tumor (spread of the original malignant cells).

Ultrasound of lymph node stations

We humans have about 600 lymph nodes which, among other things, belong to the secondary lymphatic organs together with the spleen and tonsils 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 everywhere in the body, some 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 clearly visible with ultrasound. Their number, size, and shape are examined, which often allows for distinguishing between normal, inflammatory, enlarged, or malignantly altered lymph nodes. Ultrasound examination of the lymph node stations is important in the surgical planning and follow-up of melanomas (Skin cancer), as well as in the surgical planning of malignant diseases in the head/neck area, for example in the context of thyroid carcinoma. This examination is also common in the clarification of hematological diseases (for example of the blood-forming bone marrow or the lymphatic system).

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

For this examination, ultrasound/sonography as well as Doppler sonography are used, which together represent a cross-sectional image around the vessel and also make the blood flow in the vessel visible and measurable. Thus, the common carotid artery, the internal carotid artery, the external carotid artery, and the vertebral artery can each 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 subsequently, stenoses (narrowings) can occur due to plaque deposits and calcifications, which, the further they progress, can have dangerous consequences for the patient, for example with an increased risk of stroke. This is the case, for example, with untreated high blood pressure, untreated high blood lipids, lipid metabolism disorders, diabetes, etc. Smoking/nicotine abuse can also pathologically change/narrow the arterial vessels.

With Doppler ultrasound, it is possible to detect whether there are pathological (diseased) plaques (deposits) in the vessels and how far the lumen (the diameter) of the vessel is impaired/narrowed.

In the course of this examination, the intima-media thickness (thickness of the inner vessel wall) is measured, which is an important indicator for fat and calcium deposits in other arteries (for example in the heart – Coronary artery disease [CAD] or in the legs – intermittent claudication [PAD]). This examination is necessary in the course of some surgical preparations/surgical clearances. Furthermore, aneurysms (pathological enlargement 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 exclude or detect and assess the extent of deep vein thrombosis, or DVT for short (blood clot in the deep leg veins). Thrombophlebitis (inflammation and clot of the superficial veins) or venous insufficiency in varicosity (leaky venous valves due to varicose veins) or post-thrombotic syndrome (after a thrombosis has occurred), which often lead to leg edema (swollen legs/feet), can also be diagnosed.

Thyroid ultrasound

The ultrasound of the thyroid gland includes the measurement of the size of the organ, the position of the organ, the shape, and the texture of the tissue. It plays an important role in the assessment of any cysts and lump formations, which can be detected from a size of just a few millimeters. There are numerous features 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 in ultrasound. For example, autoimmune thyroiditis – Hashimoto's disease. Ultrasound of the thyroid is also used in the context of follow-up checks or postoperative checks.

Ultrasound of the neck organs/neck soft tissues

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

Ultrasound of the abdominal wall and groin

The most common examples are inguinal hernia (groin hernia) or epigastric hernia (abdominal wall hernia/upper abdominal hernia) or incisional hernia (scar hernia). This involves a weakness and consequently a gap in the abdominal wall/scar, where subcutaneous fatty tissue, peritoneum, and intestines can protrude through the gap.

Upper abdominal ultrasound

In the upper abdomen are the liver, gallbladder, pancreas, and spleen, as well as lymph nodes and the large blood vessels, the abdominal aorta and the inferior vena cava.

For example, one can see whether the organs are within the norm regarding size and structure, or whether changes are present in the context of various clinical pictures. For example, splenomegaly (enlargement of the spleen) in an infection with Epstein-Barr virus (EBV).

Kidney ultrasound

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, and whether there is hydronephrosis (urinary backup) or other abnormalities.

Kidney transplant ultrasound (KTX)

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

Residual urine ultrasound

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

Lower abdominal ultrasound

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

Diseases of the appendix (vermiform appendix) such as appendicitis (inflammation of the appendix) can also be diagnosed. If the inflamed appendix itself cannot be seen, one can conclude this based on the clinical picture (typical pain, fever, nausea, and vomiting) and features in the ultrasound, such as ascites/free fluid and/or lymphadenopathy, and initiate timely further surgical clarification.

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

The musculoskeletal system consists of muscles, tendons and joints. With ultrasound, one can, for example, diagnose tendinitis (tendon inflammation), or partial/total rupture (tendon tear/avulsion), muscle fiber tear, joint effusion (pathological accumulation of fluid in a joint), hematoma (bruise), ganglion (benign, well-defined lesion filled with gelatinous fluid)/Baker's cyst (fluid-filled cyst typically in the medial popliteal fossa) and bursitis (inflammation of the bursa). One can also detect space-occupying lesions (benign as well as malignant) intramuscularly (within the muscle) or muscle atrophy ("wasting" of the muscle).

Breast ultrasound incl. axilla on both sides.

It should be mentioned first that an ultrasound examination alone is not suitable for breast cancer screening. From the age of 40, women in Austria are invited every two years for mammography as part of breast cancer screening (BKF) and, depending on the density of the breast tissue, for supplementary sonography of the breast on both sides.

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 frequently without concern, for example for follow-up checks of benign changes.

Men should also have any changes such as swelling, lumps, increase in size, etc., clarified. Men can, for example, develop breast tissue due to changes in the hormonal balance. Most of the time, this tissue is found retromamillary (directly behind the nipple) and can feel like a lump and be painful. If a man has true gynecomastia (breast tissue is present), then one must remember that a breast carcinoma (breast cancer) could also develop from these cells.

There are benign changes such as cysts and fibroadenomas or even normal lymph nodes within the breast. In breastfeeding women, mastitis (breast inflammation) can occur. After trauma/accident, hematoma formation (bruising) can occur in the breast.

Testicular ultrasound:

With ultrasound, the morphology ("shape") and vascularization (blood supply) of the testes and epididymides as well as the spermatic cords are examined. Tumors, inflammations, benign changes such as calcifications and cysts can be detected. Furthermore hydro- or varicoceles (fluid accumulations in the scrotum due to, for example, varicose veins).

In boys it can happen that after birth the testes (the testicles) are not palpable in the scrotum – cryptorchidism (undescended testicle) 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 descent (spontaneous "dropping" of the testicles into the scrotum) occurs within the first 6 months of life.

Please contact JUVENIS by phone at +43 1 236 3020, by e-mail at empfang@juvenismed.at or via the contact form, to arrange a consultation or treatment appointment.

We have answered the most frequently asked questions on the topic of Ultrasound examinations answered. If you have any further questions, please feel free to contact us via empfang@juvenismed.at or at +43 1 236 3020.

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